Sample records for acetabular dysplasia cup

  1. Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

    Gromov, Kirill; Greene, Meridith E; Huddleston, James I


    BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip arthrop...... should therefore take special care during placement of the acetabular component in patients with AD....


    张自明; 马瑞雪; 吉士俊; 牛之彬


    Objective To investigate the pathological mechanism of hip dysplasia. Methods The left knee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the xray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow acetabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films.Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.


    杨庆铭; 蒋垚; 孙争鸣; 钱不凡


    Acetabular dysplasia is one of the most important reasons for development ofsecondary osteoarthrosis of the hip joint. This paper introduced a method of modifiedWagner’s procedure, called acetabular rotation osteotomy for the treatment of severeacetabular dysplasia in ten adults patients. These were followed up for 1-4 years. Fivecriteria including pain, gait, range of motion, measurement of roentgenographic changees,and CT scan were evaluated. From the limited information of this paper, it showed thatin all cases pain improved and range of motion did not reduced significantly. Comparingthe pre- and post-operative x-ray films, CE angle increased and exceeded the normal val-ue. Tonnis hip value decreased and approached the normal value, anteversion of theacetabulum improved, and the percentage of acetabular coverage increased as well.

  4. MR imaging findings of acetabular dysplasia in adults

    James, Steven; Connell, David [The Royal National Orthopaedic Hospital, Radiology Department, London, Middlesex (United Kingdom); Miocevic, Miranda; Malara, Frank; Pike, Jonathan [Victoria House Hospital, Radiology Department, Melbourne (Australia); Young, David [Melbourne Orthopaedic Group, Orthopaedic Surgery, Melbourne (Australia)


    To evaluate the diagnostic accuracy of MR imaging in the identification of labral and articular cartilage lesions in patients with acetabular dysplasia. Pre-operative MR imaging was performed on 27 hips in 25 consecutive patients (16 males, 9 females, age range 19-52 years, mean age 31.2 years) with radiographic evidence of acetabular dysplasia (centre-edge angle of Wiberg <20 degrees). The average duration of symptoms was 16.2 months. Two musculoskeletal radiologists assessed MR images in consensus for the presence of abnormality involving the acetabular labrum and adjacent acetabular articular cartilage. A high resolution, non-arthrographic technique was used to assess the labrum and labral chondral transitional zone. Surgical correlation was obtained in all cases by a single surgeon experienced in hip arthroscopy and ten patients with normal hip MRI were included to provide a control group. The acetabular labra in the dysplastic hips demonstrated abnormal signal intensity, and had an elongated appearance when compared with the control group (mean length 10.9 mm vs 6.4 mm). Morphological appearances in the labra included surface irregularity, fissures and cleft formation. MR imaging correctly identified the severity of chondral abnormality in 24 of 27 hips (89%) when compared with arthroscopic findings. MR imaging demonstrates an elongated labrum, focal intra-substance signal change and irregularity and fissuring of the margins in patients with acetabular dysplasia. Abnormality is also identified at the labral chondral transitional zone, where fissuring, focal clefts, chondral deficiency and subchondral cyst formation may be apparent. A high-resolution, non-arthrographic technique can provide an accurate preoperative assessment and evaluate the presence of premature osteoarthritis. (orig.)

  5. Acetabular cup position and risk of dislocation in primary total hip arthroplasty

    Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik;


    Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We perform...

  6. Total hip arthroplasty with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis

    吴立东; 金礼斌; 严世贵; 杨泉森; 戴雪松; 王祥华


    Objective:To evaluate the outcome of total hip arthroplasty (THA) with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis.Methods: Between 1995 and 2002, we implanted 23cementless cups and femoral head autografts in 20 patients with hip dysplasia and osteoarthritis. In this study, a retrospective study was made on 21 hips in 20 patients (18females and 2 males, aged 50 years on an average) with developmental hip dysplasia treated by THA with acementless cup and femoral head autograft. The acetabular cup was placed at the level of the true acetabuinm and all the patients required autogenous femoral head grafts due to acetabular deficiency. The average rate of the acetabular cup covered by the femoral head autograft was 31%(ranging from 10% to 45%). Eight hips had less than 25%cup coverage and thirteen between 25% and 50%. The average follow-up period was 4.7 years (range, 1-8 years).The replacing outcome was evaluated by modified Harris hip score. Preoperative and follow-up radiographs were made.Results: All the autografts were united to the host bones. No autograft was collapsed or no component from the hip was loosed in all the patients. According to the modified Harris hip score, the average hip score increased from 46 before operation to 89 at the final review. Before operation, the leg-length discrepancy was greater than 2 cm in all the patients except one with bilateral hip dysplasia.After operation, only 2 out of 20 patients had a leg-length discrepancy greater than 1 cm. Three hips showed minor bone resorption in the lateral portion of the graft, which did not support the cup. Three hips developed Grade 1Brooker heterotopic ossification and one developed Grade 2.Conclusions: THA with a cementless cup and a femoral head autograft for patients with osteoarthritis resulted from hip dysplasia can result in favorable outcomes. This method can provide reliable acetabular fixation and restore the acetabular bone stock in

  7. Biomechanical investigation of ambulatory training in patients with acetabular dysplasia.

    Kanai, Akira; Kiyama, Takahiro; Genda, Eiichi; Suzuki, Yasuo


    The purpose of this study was to investigate the effectiveness and safety of ambulatory training in patients with acetabular dysplasia. To achieve this, we studied the hip joint moment in subjects walking with laterally and horizontally elevated arms and changing speeds as a form of training to strengthen hip joint abductor muscles. We studied eight women with pre- or early stage hip disease (center-edge angle of Wieberg 18.5 degrees to -3.0 degrees ) and six healthy women. In exercise task 1 the subjects walked at a rate of 90 steps/min, with abduction of 90 degrees in the shoulder joint ipsilateral or contralateral to the affected hip joint, and either no load or a 1 kg weight in either hand. In exercise task 2, walking speed was changed in three stages from 60 steps/min (s-gait), 90 steps/min (n-gait), and 120 steps/min (f-gait), with both hands swinging freely. Using results from a three-dimensional motion analysis system, the hip joint moments were calculated. In both the healthy and the acetabular dysplasia groups, the abduction moment of the hip joint decreased significantly with ipsilateral elevation and increased significantly with contralateral elevation. There was no significant change in hip flexion moment in either group. The hip extension moment decreased significantly with contralateral elevation, but no significant changes were seen in ipsilateral elevation. In the walking rate variation, the extension hip moment in fast gait was higher than in slow gait. It was concluded that ambulatory training with contralateral horizontal arm elevation may be an effective way of increasing hip joint abductor muscle strength. Ipsilateral arm elevation decreases gluteus medius muscle tension and is an effective way of ambulatory training for people with compensated trendelenburg gait. Variable speed walking is an effective exercise method that can strengthen extensor muscles. Therefore, these ambulatory training methods are useful for acetabular dysplasia patients.

  8. Trabecular metal acetabular revision system (cup-cage construct to address the massive acetabular defects in revision arthroplasty

    Rajesh Malhotra


    Full Text Available The increasing number of total hip replacements in the younger clique has added to the demand for revision procedures. Revision situations are often encountered with infection, loss of bone stock and bone defects. There are various methods of reconstruction of acetabular defects. The management options of type 3B Paprosky acetabular defects are limited with allograft and conventional cages. Trabecular metal technology has evolved to address these bone defects. Trabecular metal acetabular revision system (TMARS cup-cage construct is a new technique to address massive acetabular defects. We describe a case of failed hip reconstruction done for a Giant cell tumour of proximal femur managed by a two stage procedure, initial debridement and second stage reconstruction of acetabulum with TMARS cup-cage construct and femur with allograft prosthesis composite.

  9. Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia

    Ito, Hiroshi; Matsuno, Takeo; Hirayama, Teruhisa; Tanino, Hiromasa; Yamanaka, Yasuhiro [Asahikawa Medical College, Department of Orthopaedic Surgery, Asahikawa (Japan); Minami, Akio [Hokkaido University School of Medicine, Department of Orthopaedic Surgery, Sapporo (Japan)


    Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT). Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software. The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001). Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score. (orig.)

  10. Increasing thickness and fibrosis of the cartilage in acetabular dysplasia: a rabbit model research

    LI Tian-you; MA Rui-xue


    Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp's angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp's angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.

  11. Research synthesis of recommended acetabular cup orientations for total hip arthroplasty.

    Harrison, Claire L; Thomson, Avril I; Cutts, Steven; Rowe, Philip J; Riches, Philip E


    Total hip arthroplasty (THA) is regarded as one of the most successful surgical procedures of modern times yet continues to be associated with a small but significant complication rate. Many early failures may be associated with poor component positioning with, in particular, acetabular component orientation dependent on the subjective judgement of the surgeon. In this paper, we compare the manufacturers' instructions on acetabular cup orientation with the literature-based recommended safety zones and surgical technique, by transforming them onto a single, clinically-relevant framework in which the different reference systems, safety guidelines and current instrumentation surgical techniques can be evaluated. The observed limited consensus between results reflects ongoing uncertainty regarding the optimum acetabular component positioning. As malpositioning of the acetabular cup increases the risk of revision surgery, any ambiguity over the correct position can have a causal effect. Our analysis highlights the need for a surgical reference system which can be used to describe the position of the acetabular cup intra-operatively.

  12. Impaction bone grafting and a cemented cup after acetabular fracture

    Bronsema, E.; Stroet, M.A. Te; Zengerink, M.; Kampen, A. van; Schreurs, B.W.


    PURPOSE: Patients suffering from post traumatic osteoarthritis of the acetabulum often require a total hip arthroplasty at a relatively young age. Long-term data outcome studies for this population are lacking. We report on the long-term outcome of 20 acetabular fractures in 20 patients treated with

  13. Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position

    Troelsen, Anders; Mikkelsen, Lone Rømer; Jacobsen, Steffen;


    The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous preva...

  14. The role of the acetabular labrum in hip dysplasia

    Hartig-Andreasen, Charlotte; Søballe, Kjeld; Troelsen, Anders


    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should...

  15. 髋臼发育不良髋关节置换前髋臼侧的三维测量%Three-dimensional measurement of acetabular side before arthroplasty for acetabular dysplasia

    许杰; 马若凡; 李登; 蔡志清; 李亮平


    BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.%背景:成人髋臼发育不良髋臼小而浅,臼内有大量骨痂和瘢痕组织等都为人工髋关节置换术中真臼的辨认、臼杯的准确安装带来极大困难,关节置换前对髋臼的全面认识是选择合适的髋臼假体和制定个性化髋臼重建方案的前提。目

  16. The efficacy of a “double-D-shaped” wire marker for radiographic measurement of acetabular cup orientation and wear

    Derbyshire, Brian; Raut, Videshnandan V.


    Historically, wire markers were attached to cemented all-plastic acetabular cups to demarcate the periphery and to measure socket wear. The wire shape was either a semi-circle passing over the pole of the cup, or a circle around the cup equator. More recently, “double-D” shaped markers were introduced with a part-circular aspect passing over the pole and a semi-circular aspect parallel to the equatorial plane. This configuration enabled cup retroversion to be distinguished from anteversion. I...

  17. Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

    Ghanem, Mohamed


    Full Text Available Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR in multi-morbid patients.Patients and methods: During the period from January 1 2007 to December 31 2011 19 revision hip surgeries were performed in , in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%. All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months. Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%.Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%. The most common complication encountered was the proximal migration of the bipolar head.The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%. Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as well

  18. The effect of geometry and abduction angle on the stresses in cemented UHMWPE acetabular cups – finite element simulations and experimental tests

    Santavirta Seppo S


    Full Text Available Abstract Background Contact pressure of UHMWPE acetabular cup has been shown to correlate with wear in total hip replacement (THR. The aim of the present study was to test the hypotheses that the cup geometry, abduction angle, thickness and clearance can modify the stresses in cemented polyethylene cups. Methods Acetabular cups with different geometries (Link®: IP and Lubinus eccentric were tested cyclically in a simulator at 45° and 60° abduction angles. Finite element (FE meshes were generated and two additional designs were reconstructed to test the effects of the cup clearance and thickness. Contact pressures at cup-head and cup-cement interfaces were calculated as a function of loading force at 45°, 60° and 80° abduction angles. Results At the cup-head interface, IP experienced lower contact pressures than the Lubinus eccentric at low loading forces. However, at higher loading forces, much higher contact pressures were produced on the surface of IP cup. An increase in the abduction angle increased contact pressure in the IP model, but this did not occur to any major extent with the Lubinus eccentric model. At the cup-cement interface, IP experienced lower contact pressures. Increased clearance between cup and head increased contact pressure both at cup-head and cup-cement interfaces, whereas a decreased thickness of polyethylene layer increased contact pressure only at the cup-cement interface. FE results were consistent with experimental tests and acetabular cup deformations. Conclusion FE analyses showed that geometrical design, thickness and abduction angle of the acetabular cup, as well as the clearance between the cup and head do change significantly the mechanical stresses experienced by a cemented UHMWPE acetabular cup. These factors should be taken into account in future development of THR prostheses. FE technique is a useful tool with which to address these issues.

  19. Trabecular metal cup without augments for acetabular revision in case of extensive bone loss and low bone-prosthesis contact.

    Pierannunzii, L; Mambretti, A; D'Imporzano, M


    Current evidences in revision hip arthroplasty suggest to treat severe acetabular bone loss with dedicated implants, such as anti-protrusio cages, stemmed cups, modular systems supplied with iliac flanges and obturatory hook. However recent literature is reporting satisfactory outcomes with simple elliptical Trabecular Metal cups. Purpose of the study was to evaluate mid-term results of such a surgical procedure. All hip revisions performed from 2008 to 2009 with implantation of a TMT multi-hole acetabular cup without augmentations were retrospectively reviewed. The cases with low-degree acetabular bone loss (stage I and II according to GIR classification), with surgical report poorly describing the bone defect, with inadequate pre- and post-operative x-rays were ruled out. Twenty-five cases were identified, but four were lost to follow-up. The twenty-one patients were 71 year-old on average (from 60 to 82), with stage IV bone loss in 6 cases and stage III bone loss in 15 cases. Mean interval from surgery to evaluation was 20.9 months (from 13 to 30). The evaluation included bone-prosthesis contact estimation, component position, survivorship, complications, final Harris Hip Score, presence of periprosthetic radiolucencies. Host bone-prosthesis contact was estimated to be about 35%. Only three implant were subsequently reoperated (for infection, early migration, recurrent dislocation). The HHS among non-reoperated 18 patients was 81.96 on average (from 63.44 to 95.82). Six cases showed thin radiolucencies in one of the three Charnley zones, while three cases showed radiolucencies in two. None of these images was evolutive, thus they were not considered signs of loosening. The mid-term results of this series confirm the hypothesis that a porous tantalum acetabular cup is an effective option to deal with difficult acetabular revisions. Although no extra-acetabular fixation device is available, the very high surface friction guaranteed by the material and the

  20. The efficacy of a "double-D-shaped" wire marker for radiographic measurement of acetabular cup orientation and wear.

    Derbyshire, Brian; Raut, Videshnandan V


    Historically, wire markers were attached to cemented all-plastic acetabular cups to demarcate the periphery and to measure socket wear. The wire shape was either a semi-circle passing over the pole of the cup, or a circle around the cup equator. More recently, "double-D" shaped markers were introduced with a part-circular aspect passing over the pole and a semi-circular aspect parallel to the equatorial plane. This configuration enabled cup retroversion to be distinguished from anteversion. In this study, the accuracy of radiographic measurement of cup orientation and wear was assessed for cups with "double-D" and circular markers. Each cup was attached to a measurement jig which could vary the anteversion/retroversion and internal/external rotation of the cup. A metal femoral head was fixed within the socket and radiographic images were created for all combinations of cup orientation settings. The images were measured using software with automatic edge detection, and cup orientation and zero-wear accuracies were determined for each setting. The median error for cup version measurements was similar for both types of wire marker (0.2° double-D marker, -0.24° circular marker), but measurements of the circular marker were more repeatable. The median inclination errors were 2.05° (double-D marker) and 0.23° (circular marker). The median overall "zero wear" errors were 0.19 mm (double-D marker) and 0.03 mm (circular marker). Measurements of the circular wire marker were much more repeatable.

  1. Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

    Burke, Neil G


    Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

  2. Surface-gradient cross-linked polyethylene acetabular cups: oxidation resistance and wear against smooth and rough femoral balls.

    Shen, Fu-Wen; McKellop, Harry


    Two methods were developed and evaluated for cross-linking the bearing surface of a polyethylene acetabular cup to a limited depth, in order to improve its resistance to wear without degrading the mechanical properties of the bulk of the component. In the first method, low-energy electron beams were used to cross-link only the bearing surface of the cups to a maximum depth of about 2 mm. The cups then were annealed at 100 degrees C in vacuum for 3 or 6 days to reduce the residual free radicals, and the resultant resistance to oxidation was compared by artificially aging the cups at 80 degrees C in air. Chemically cross-linked surface layers were produced by coating the bearing surfaces of the cups with a thin layer of polyethylene powder mixed with 1% weight peroxide, and compressing them at 6.9 MPa (1000 psi) and 170 degrees C. This resulted in a cross-linked surface layer that extended about 3 mm deep, with a gradual transition to conventional (noncross-linked) polyethylene in the bulk of the implant. In hip simulator wear tests with highly polished (implant quality) femoral balls, both types of surface cross-linking were found to improve markedly the wear resistance of the acetabular cups. In tests with roughened femoral balls, the wear rates were much higher and were comparable to those obtained with similarly roughened balls against noncross-linked polyethylene cups in a previous study, indicating that the full benefit of cross-linking may not be realized under conditions of severe third-body abrasion. Nevertheless, these results show a promising approach for optimizing the wear resistance and the bulk mechanical properties of polyethylene components in total joint arthroplasty.

  3. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults; Association with bone scintigraphic findings

    Nakamura, Nobuo; Ozono, Kenji; Sugano, Nobuhiko; Takaoka, Kunio; Ono, Hiroo (Osaka Univ. (Japan). Faculty of Medicine)


    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.).

  4. Assessment of Accuracy and Reliability in Acetabular Cup Placement Using an iPhone/iPad System.

    Kurosaka, Kenji; Fukunishi, Shigeo; Fukui, Tomokazu; Nishio, Shoji; Fujihara, Yuki; Okahisa, Shohei; Takeda, Yu; Daimon, Takashi; Yoshiya, Shinichi


    Implant positioning is one of the critical factors that influences postoperative outcome of total hip arthroplasty (THA). Malpositioning of the implant may lead to an increased risk of postoperative complications such as prosthetic impingement, dislocation, restricted range of motion, polyethylene wear, and loosening. In 2012, the intraoperative use of smartphone technology in THA for improved accuracy of acetabular cup placement was reported. The purpose of this study was to examine the accuracy of an iPhone/iPad-guided technique in positioning the acetabular cup in THA compared with the reference values obtained from the image-free navigation system in a cadaveric experiment. Five hips of 5 embalmed whole-body cadavers were used in the study. Seven orthopedic surgeons (4 residents and 3 senior hip surgeons) participated in the study. All of the surgeons examined each of the 5 hips 3 times. The target angle was 38°/19° for operative inclination/anteversion angles, which corresponded to radiographic inclination/anteversion angles of 40°/15°. The simultaneous assessment using the navigation system showed mean±SD radiographic alignment angles of 39.4°±2.6° and 16.4°±2.6° for inclination and anteversion, respectively. Assessment of cup positioning based on Lewinnek's safe zone criteria showed all of the procedures (n=105) achieved acceptable alignment within the safe zone. A comparison of the performances by resident and senior hip surgeons showed no significant difference between the groups (P=.74 for inclination and P=.81 for anteversion). The iPhone/iPad technique examined in this study could achieve acceptable performance in determining cup alignment in THA regardless of the surgeon's expertise. [Orthopedics. 2016; 39(4):e621-e626.].

  5. Acetabular defect reconstruction with impacted morsellized bone grafts or TCP/HA particles. A study on the mechanical stability of cemented cups in an artificial acetabulum model.

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.


    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  6. A Novel Method for Assessment of Polyethylene Liner Wear in Radiopaque Tantalum Acetabular Cups

    Troelsen, Anders; Greene, Meridith E; Ayers, David C


    Conventional radiostereometric analysis (RSA) for wear is not possible in patients with tantalum cups. We propose a novel method for wear analysis in tantalum cups. Wear was assessed by gold standard RSA and the novel method in total hip arthroplasty patients enrolled in a randomized controlled...... to the gold standard in titanium cups. The novel method offered accurate assessment and is a viable solution for assessment of wear in studies with tantalum cups....

  7. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)


    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  8. Oxidation in ultrahigh molecular weight polyethylene and cross-linked polyethylene acetabular cups tested against roughened femoral heads in a hip joint simulator.

    Taddei, Paola; Affatato, Saverio; Fagnano, Concezio; Toni, Aldo


    This study was aimed at comparing the oxidative degradation of commercial acetabular cups made of cross-linked polyethylene (XLPE) and conventional ultrahigh molecular weight polyethylene (UHMWPE). After testing against deliberately scratched CoCrMo femoral heads in a hip joint simulator, the cups, microtomed parallel to the articulating surface, were analyzed by IR spectroscopy. Due to the potential for artifacts caused by absorbed contaminants, the IR spectra were compared only after hexane extraction; actually, XLPE was found to absorb more serum than UHMWPE. The two sets of unworn acetabular cups showed different oxidation patterns with consequently different distributions of carbonyl species; unworn XLPE was characterized by lower contents of carbonyl species and hydrogen-bonded alcohols and higher contents of trans-vinylene species than unworn UHMWPE. Upon simulator testing, UHMWPE showed more significant changes in oxidation indexes and distribution of carbonyl compounds than XLPE, confirming a better wear behavior for XLPE under the adopted testing conditions.

  9. [Poor results in 183 threaded acetabular cups at a mean 7 years follow-up].

    Lecestre, P; Poilbout, P; Dambreville, A; Vial, D


    We reviewed 183 threaded rings at a mean 7 years follow-up. Poor résults are frequent: 34 % had been revised and 50 % have radiographic migration, essentially with proximal migration of the cup. Generally, we reoperated with other cememtless implants. The type of threaded cup does not matter (spheric or conic). Only the duration of follow up seems significant. We think that biomecanical strains, rather than physiology, explain these numerous migrations. We have therefore abandoned threaded cups in favour of porous-coated impacted cups.

  10. Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years.

    Schreurs, B.W.; Zengerink, M.; Welten, M.L.M.; Kampen, A. van; Slooff, T.J.J.H.


    The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.3 years; range, 35-75 years) that were

  11. The relative influence of five variables on the in vitro wear rate of uncrosslinked UHMWPE acetabular cup liners.

    Lewis, Gladius; Fencl, Robert M; Carroll, Michael; Collins, Tim


    The wear factors, k(exp)(in 10(-6)mm(3)N(-1)m(-1)), of two sets of hemispherical uncrosslinked ultra-high-molecular-weight polyethylene UHMWPE acetabular cup liners, when articulated against 28-mm-diameter Co-Cr alloy femoral heads, were determined in a hip joint wear simulator. All test conditions used were the same for both sets, with the exception that in one set (comprising six liners), the bovine serum concentration in the test lubricant (P) was 25vol%, while it was 90vol% for the other set (comprising seven liners). For each liner in each set, the values of the following independent or explanatory variables were determined: the tensile toughness (U, in MJm(-3)) of the UHMWPE; the degree of crystallinity (%C) of the UHMWPE; the mean surface roughness (R(a), in microm) of the liner; and the radial clearance between the femoral head and the liner (DeltaL, in mm). All the results in both sets were combined and correlational analyses were performed between k(exp), on the one hand, and various combinations of U, %C,R(a),DeltaL, and P, on the other hand. It was found that the strongest correlations were obtained when P was included, but that %C and U are also important variables. Within the range of values of the independent variables used, the recommended relationship isk(exp)=460U(0.72)%C(-5.29)P(-0.66)(adjustedr(2)=0.858). This relationship has many potential uses, such as for screening uncrosslinked UHMWPEs that are being considered as candidates for fabricating acetabular cup liners, and for conducting studies of the sensitivity of k(exp) to a change in a value of a specified independent variable (with the values of all the other independent variables held constant). These uses, as well as the study limitations, are discussed in detail.

  12. Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

    Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))


    Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

  13. Learning curve of acetabular cup positioning in total hip arthroplasty using a cumulative summation test for learning curve (LC-CUSUM).

    Lee, Young-Kyun; Biau, David J; Yoon, Byung-Ho; Kim, Tae-Young; Ha, Yong-Chan; Koo, Kyung-Hoi


    Despite advances in surgical techniques and instrumentation, optimal cup positioning in total hip arthroplasty (THA) is challenging with a limited accuracy. We evaluated whether a learning curve exists for the optimal cup positioning, using the LC-CUSUM test (Learning curve cumulative summation test). We evaluated the first 100 consecutive THA performed by two surgeons, who had a year of fellowship training in the same teaching hospital. A learning curve of cup positioning was plotted in each series using the LC-CUSUM score. There was no significant difference of numbers of outlier between two surgeons (P = 0.079). Both surgeons completed the learning curve of optimal cup positioning before 50 procedures, and maintained competence. A substantial learning period is necessary in the optimal positioning of an acetabular cup.

  14. A porous tantalum uncemented acetabular cup in acetabular revision arthroplasty%生物学固定骨小梁金属杯在髋臼翻修中的应用

    徐卫东; 陈刚; 张东华


    前后X射线平片显示无假体移位下沉等不稳迹象,骨小梁金属杯周围骨质向内长入.本组患者无置换后并发症发生,截至最后1次随访有14例行走时无疼痛,2例轻度疼痛伴轻度跛行.未出现症状性深静脉血栓或神经损伤.无需要再度翻修病例.结论:初次固定人工髋臼杯失败的病例,若无骨缺损,翻修时使用骨小梁金属杯可以获得良好的早期效果.%BACKGROUND: Biological fixation refers to the treatment of coarse or porous prosthetic surface. It is favorable to "bone ingrowth" prosthesis to achieve long-term stability. Porous tantalum is the latest scientific product that appears suitable to prosthetic surface owing to its porous feature and has been attracting a great deal attention.OBJECTIVE: To investigate the therapeutic efficacy of a porous tantalum uncemented acetabular cup in acetabular revision arthroplasty.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA between April and November 2006.PARTICIPANTS/MATERIALS: Sixteen patients (16 hips), 7 males and 9 females, aged 54-81 years old, who received treatment at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA were included in this study. Of these patients, 2 suffered from femoral neck fracture, 6 from aseptic femoral head necrosis, and 8 from osteoarthritis. Trabecular metal cup (Zimmer, Warsaw, Indiana) provided a titanium alloy bottom layer and porous tantalum-coated surface, which was realized by technical combination of bone trabecular tantalum and titanium alloy. The prosthesis contained an ultrahigh modulus polyethylene lining.METHODS: All patients underwent acetabular revision with modular porous tantalum uncemented acetabular cup. Prior to replacement, acetabular defects and femoral prosthesis were evaluated. A posterolateral approach of hip joint was made. Following

  15. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)


    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  16. Pre-clinical studies to validate the MITCH PCR Cup: a flexible and anatomically shaped acetabular component with novel bearing characteristics.

    Latif, Ahmed M H; Mehats, Aude; Elcocks, Martyn; Rushton, Neil; Field, Richard E; Jones, Eric


    A previous clinical study was undertaken to evaluate the safety and efficacy of an anatomically shaped, flexible acetabular cup. Clinical results achieved were satisfactory, although some deficiencies in the model were identified. Design changes to the original model have been implemented to improve both initial stability and long term biological fixation. This was achieved through modifications made to both the anchoring mechanism and by the application of an appropriate backing surface layer promoting bone on-growth. In addition, changes to the articulation couple have also been introduced to improve implant durability and bearing performance, utilising a carbon fibre reinforced polyetheretherketone--alumina couple. Simulated loading, in both models, was performed using Finite Element Analysis. Mechanical and tribological tests were also performed to ensure the robustness of the new optimised design. Bio-compatibility of the articulation couple was demonstrated using an animal model. Implantation of the device has been extensively tested and re-validated in vitro to achieve a favourable polar contact between cup and femoral head and establish a reproducible operative technique. This preliminary work is undertaken prior to commencing a post market surveillance study of the CE marked implant.

  17. Mechanical analysis of total hip replacement with cup of different diameters in patients with developmental dysplasia of hip%髋臼发育不良者全髋置换中置入不同直径髋臼杯的力学分析

    许杰; 马若凡; 蔡志清; 李登


    背景:成人髋臼发育不良髋臼小而浅,臼内有大量骨痂和瘢痕组织等都为人工髋关节置换臼杯安装带来极大困难。臼杯安装后局部的力学变化关系到置换后假体松动的发生及使用寿命。  目的:利用三维有限元力学分析方法,对髋关节发育不良患者采用不同直径臼杯置入,观察对髋臼假体-骨界面间应力分布情况的影响。  方法:选取髋关节发育不良患者的骨盆为试验对象,用螺旋 CT 做全长连续扫描,然后利用计算机仿真技术对 CT 图像进行三维重建,建立髋关节发育不良骨盆模型。在计算机环境中对重建模型进行不同直径臼杯置入的模拟手术,利用有限元分析软件对重建模型进行有限元网格化及力学分析。  结果与结论:对于髋臼发育不良的病例,选择小直径臼杯可应对髋臼浅平、骨床骨量不足的缺陷而达到较好的臼杯骨床包容,但臼杯直径小致接触面小使单位面积应力升高;另一方面,大直径臼杯置入扩大磨锉髋臼骨床可引起髋内壁破损突破,导致应力(包括压应力及剪切力)增大及集中。由此推断,髋臼发育不良全髋关节置换时应在保证骨床包容的前提下选择较大直径的臼杯,有利于应力的良好分布,但应尽量避免或减少扩大磨锉髋臼骨床所致髋臼内壁的穿破。%BACKGROUND:The anatomical structure of acetabulum is different for the developmental dysplasia of the hip, which is smal and shal ow, with abundant cal us and scar tissue. It is difficult to determine the diameter of cup and instal ation of the cup during arthroplasty. Loosening and survival of postoperative prosthesis were influenced by local mechanical changes. OBJECTIVE:Using the three-dimensional finite element analysis, the stress distribution in acetabular cup-bone interface after implanting cups with different diameters was studied during total hip

  18. Analysis of Relative Motion between Femoral Head and Acetabular Cup and Advances in Computation of the Wear Factor for the Prosthetic Hip Joint

    O. Calonius


    Full Text Available The amount and type of wear produced in the prosthetic hip joint depends on the type of relative motion between the femoral head and the acetabular cup. Wear particles removed from the bearing surfaces of the joint can cause adverse tissue reactions resulting in osteolysis and ultimately in loosening of the fixation of the implant. When designing a simulator for evaluation of prospective materials for artificial hip joints it is important to verify that the type of relative motion at the articulation is similar to that produced in walking, involving continually changing direction of sliding. This paper is an overview of recent research done at Helsinki University of Technology on the analysis of the relationship between relative motion and wear in the prosthetic hip joint.To analyze the relative motion, software for computing tracks, referred to as slide tracks, drawn on the counterface by marker points on the bearing surface was developed and experimentally verified. The overall relative motion of the joint was illustrated by a slide track pattern, produced by many points. The patterns resulting from walking motion and from motion produced in ten contemporary hip simulator types were compared. The slide track computations were not limited to illustrational purposes but offered a basis for computing variations of sliding distances, sliding speeds and direction of sliding during a cycle. This was done for the slide track termed the force track, drawn by the resultant contact force. In addition, the product of the instantaneous load and increment of sliding distance was numerically integrated over a cycle. This track integral of load had so far not been determined for the majority of contemporary hip simulators. The track integral can be used in determining the wear factor, making it possible to compare clinical wear rates with those produced by hip simulators. The computation of the wear factor was subsequently improved by replacing the track

  19. Effect of acetabular cup design on metal ion release in two designs of metal-on-metal hip resurfacing.

    Cadossi, Matteo; Tedesco, Giuseppe; Savarino, Lucia; Baldini, Nicola; Mazzotti, Antonio; Greco, Michelina; Giannini, Sandro


    The purpose of this observational prospective cohort study was to evaluate the serum concentrations of cobalt (Co), chromium (Cr), and nickel (Ni) at a 2-year follow-up in patients operated on with a novel design of hip resurfacing: Romax resurfacing system (RRS). RRS is characterized by the presence of an acetabular notch which theoretically provides a wider range of motion and a reduced incidence of groin pain. The presence of radiolucencies and functional outcome, assessed using the Harris hip score (HHS) and the University of California Activity scale (UCLA), were secondary endpoints. Moreover, these results were compared with those obtained in our previous study from a similar cohort of patients implanted using the Birmingham Hip Resurfacing (BHR) system. At a 2-year follow-up, the serum levels of Co in patients operated on using the RRS were five times higher (p = 0.0002) than those found before surgery (Co, means: 1.04 and 0.20 ng/mL, respectively); similarly, Cr levels were 13 times higher (p < 0.0001) at a 2-year follow-up than before surgery (Cr, means: 1.69 and 0.13 ng/mL, respectively). Ni concentrations (0.42 and 0.78 ng/mL) were not significantly different (p = 0.16), even if they increased 86% after surgery. In the RRS patients, an inverse correlation was found between Co and Cr concentrations and length of follow-up (Co: r = -0.64, p = 0.0096; Cr: r= -0.45, p = 0.08). The serum levels of Co and Cr were not significantly different between RRS (Co: 1.04 ng/mL and Cr: 1.69 ng/mL) and BHR (Co: 1.39 ng/mL and Cr: 2.30 ng/mL) patients at 2 years (p = 0.95 and 0.26 for Co and Cr, respectively). Our results showed that RRS patients achieved an excellent clinical outcome with limited metal ion release.

  20. Bernese periacetabular osteotomy for the treatment of acetabular dysplasia%Bernese髋臼周围截骨治疗髋臼发育不良★



      背景:改变髋臼朝向是纠正髋臼发育不良的最好方法,而Bernese髋臼周围截骨是当前最常应用也是最成功的治疗方法之一。目的:总结分析Bernese髋臼周围截骨的适应证及技术和影响效果的因素,以期更好的应用于临床。方法:使用“Bernese osteotomy,Ganz osteotomy,periacetabular ostetomy”作为关键词,采用计算机检索PubMed、Elsevier和Springer数据库中2012年12月以前的相关文章。纳入与Bernese髋臼周围截骨治疗在髋臼发育不良患者中临床应用的相关文献;排除重复研究和Meta分析类文章。重点对Bernese髋臼周围截骨治疗的适应证及技术和治疗效果的影响因素进行综合分析。结果与结论:计算机初检得到483篇文献,根据纳入排除标准,对其中43篇文献进行分析。Bernese截骨术是采用改良的Smith-Peterson入路在髋臼周围进行多边形截骨。虽然手术技术逐渐改进,但是主要截骨步骤一直保持不变,只是改良了软组织松解方法。影响Bernese髋臼周围截骨治疗后效果的直接因素是影像学上髋关节退变和发育不良的严重程度。将来随着对髋关节畸形理解的深入,Bernese髋臼周围截骨治疗的指征、技术方式也将得到发展。%BACKGROUND:Changing the acetabular orientation is the best method for the treatment of acetabular dysplasia, and Bernese periacetabular osteotomy is one of the most commonly used and successful treatment methods. OBJECTIVE:To review and analyze the operation indication, surgical technique and influencing factors of Bernese periacetabular osteotomy for better clinical application. METHODS:The PubMed database, Elsevier database and Springer database were retrieved for related articles published before December 2012 with the key words of“Bernese osteotomy, Ganz osteotomy, periacetabular ostetomy”. The articles that related to the clinical application of Bernese

  1. Wear analysis by applying a pin-disc configuration to phemoral head and acetabular cup Análisis del desgaste de la articulación cabeza femoral–copa acetabular mediante simulación experimental con máquina perno-disco

    Beltrán-Fernandez Juan Alfonso


    Full Text Available This work determines a prosthetic hip system’s life-span, focusing on a Mexican phenotype. The total sliding equivalent distance for the system was determined, as well as the loading regime under which the femoral component and the acetabular cup were subjected in normal operating conditions. An experimental tribology essay was then performed to simulate the wearing of the components in a Pin over Disc machine. This assay (for which the test specimens were manufactured in medical grade stainless steel AISI-ASTM 316L for the femoral component and high density polyethylene for the acetabular cup was aimed at simulating wear conditions involved in 10 years of continuous operation. A numerical simulation of operational conditions (using the finite element method was performedIn for establishing assay loading conditions to accurately determine where the loads should be applied. The tribology assay led to quantifying the volumetric loss of materials for the system being analysed. It can be concluded that the methodology proposed in this work for estimating the life-span of a prosthetic hip system was valid and accurate by comparing the results with those found in the literature. A statistical validation of the proposed method is plaaned for the future. Key words: Design life; femoral component; acetabular cup; Mexican phenotype; pin-disc configuration.Este trabajo presenta un estudio que permite establecer la vida útil esperada de un sistema prostético de cadera para el caso del fenotipo mexicano. En primera instancia se determinó la distancia total equivalente de deslizamiento y las condiciones de carga entre el componente femoral y la copa acetabular bajo condiciones normales de carga. Posteriormente, se desarrolló una simulación experimental para la realización de un ensayo tribológico en una máquina de desgaste del tipo Perno sobre Disco (Pin on Disk, POD. Este ensayo sometió al conjunto fabricado en acero inoxidable AISI

  2. Measuring acetabular cup orientation on antero-posterior radiographs of the hip after total hip arthroplasty with a vector arithmetic radiological method. Is it valid and verified for daily clinical practice?

    Craiovan, B.; Weber, M.; Worlicek, M.; Schneider, M.; Springorum, H.R.; Grifka, J.; Renkawitz, T. [University Medical Center Regensburg, Bad Abbach/Regensburg (Germany). Orthopedic Surgery; Zeman, F. [University Medical Center Regensburg, Bad Abbach/Regensburg (Germany). Center for Clinical Studies


    The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was -1.4 ±3.9 for inclination and 0.8 ±7.9 for anteversion with excellent correlation for inclination (r=0.81, p < 0.001) and moderate correlation for anteversion (r=0.65, p < 0.001). The intraclass correlation coefficient for measurements on radiographs ranged from 0.98 (95%-CI: 0.98; 0.99) for the first observer to 0.94 (95%-CI: 0.92; 0.96) for the second observer. The interrater reliability was 0.96 (95%-CI: 0.93; 0.98) for inclination and 0.93 (95%-CI: 0.85; 0.96) for anteversion. The largest errors in measurements were associated with an extraordinary pelvic tilt. In order to get a valuable measurement for measuring cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future.

  3. Safe range of artificial acetabular cup installation angle for different head-neck ratios%头颈比不同人工髋关节臼杯安置角度的安全范围

    张振华; 孙付杰; 胡克正; 聂文波; 汪明星


    BACKGROUND:Improper angle of prosthesis placement often induces acetabular cup impact, and limits the scope of activity of artificial hip joint, and cannot meet the requirement of daily life. At present, the angle of acetabular cup instal ation remains controversial during total hip arthroplasty. Moreover, there is lack of targeted guide for the acetabular cup instal ation during hip arthroplasty with different head-neck ratios. OBJECTIVE:To explore the safe range of the artificial acetabular cup instal ation angle for different head-neck ratios. METHODS:In accordance with the calculation formula of range of internal rotation and external rotation, abduction and adduction, flexion and extension after total hip replacement, interpretation of dynamical variety law of acetabular abduction and anteversion, and deriving inequalities depending on Widmer’s standard of artificial hip joint normal activities range:(1) external rotation range was at least 40°, and internal rotation range was at least 80°. (2) Abduction range was at least 50°, and adduction range was at least 50°. (3) Anteflexion range was at least 130°, and extension range was at least 40°. The safety scope of artificial hip joint instal ation angle at different head-neck ratios was determined by solving the above three groups of inequality. RESULTS AND CONCLUSION:The safe range of the artificial acetabular cup instal ation angle for different head-neck ratios was different. To meet the normal hip joint activities, the head-neck ratios of artificial hip should be greater than 22/12. Artificial hip joint activities gradual y increase with the enlargement of head neck ratios. With enlarging the head-neck ratios, the acetabular cup instal ation safety angle scope of abduction and anteversin gradual y increases and the extreme of abduction increases gradual y, then with anteversion increasing gradual y, the abduction upper extreme of the security scope gradual y decrease and lower extreme of the

  4. Osteocondroma acetabular Acetabular osteochondroma

    Reynaldo Jesus Garcia


    Full Text Available Apresentamos o relato de um caso de osteocondroma solitário acetabular, tumor ósseo comum em diversas regiões do esqueleto porém raro nesta localização. O tratamento realizado foi a ressecção do tumor por uma via posterior ao quadril e o paciente evoluiu com resolução do quadro clínico.This is a case report of a patient with a intra-articular hip osteochondroma, an extremely rare location for this kind of lesion. The patient was treated with resection of the lesion and presented a very good evolution with total recovery of the hip movements.

  5. 陀螺仪在全髋置换髋臼杯定位中的应用%Application of gyroscope to acetabular cup positioning in total hip arthroplasty

    葛兴涛; 葛兴华; 尚春暖; 王增涛


    BACKGROUND:Good position of acetabular prosthesis during total hip replacement plays a key role in success of the operation. Traditional location tool has poor accuracy, is too complicated, and limits its application. OBJECTIVE:To compare the advantages and disadvantages of gyroscope with the traditional technique in acetabular component orientation in total hip arthroplasty. METHODS:Using lateral approach, physicians with different experiences used traditional technique to locate acetabular cup 100 times (20 times in each person; 40° abduction and 15° anteversion), and then used gyroscope to locate 60 times at the same angle in the same plastic hip model. The error between the planed and measured values was recorded. RESULTS AND CONCLUSION: Compared to the traditional technique, the error of the abduction and anteversion decreased obviously. These indicated that the gyroscope can make the orientation of acetabular component more precise in total hip arthroplasty.%背景:全髋置换中良好的髋臼假体方位对于手术的成功起到了至关重要的作用。传统定位工具或精确度欠佳、或太过繁琐,限制了其应用。  目的:对比陀螺定位仪与传统定位技术在全髋置换髋臼杯定位中的优劣。  方法:应用外侧入路,在同一个塑料髋部模型上由不同经验年限的医生利用传统方法进行了100次髋臼杯定位(每人20次40°外展和15°前倾);再利用陀螺定位仪分别进行了60次相同角度的定位,记录实测角度与事先设定角度的误差。  结果与结论:与传统技术相比,使用螺仪定位仪测量的外展角和前倾角误差明显下降。提示陀螺定位仪能使全髋置换中髋臼杯的定位更加精确。

  6. Application of porous tantalum in acetabular revision after total hip arthroplasty%多孔金属钽髋臼在全髋关节置换术后髋臼翻修中的应用

    李亮; 赵阳; 王志强


    To review the application effects of the porous tantalum acetabular cup in acetabular revision for acetabular failure after total hip arthroplasty ( THA ). The related literatures about the characteristics of porous tantalum and its application in acetabular revision in recent 10 years were retrieved from China National Knowledge Internet ( CNKI ) and PubMed databases, and a review was made. The porous tantalum acetabular cup had unique high porosity, low elasticity, high friction coefficient and good function to promote bone ingrowth inwardly. Good clinical results could be obtained using the porous tantalum acetabular cup in acetabular revision for patients with initial fixation failure using the artificial acetabular cup. In acetabular revision, the porous tantalum acetabular cup can provide superior mechanical stability, with good early and medium-term results.

  7. Angle of acetabular cup in total hip replacement affects the safety of joint flexion and extension%全髋关节置换中臼杯放置角度对关节屈伸活动安全性的影响

    邵建树; 厉晓龙; 刘伟峰; 朱州; 蒋小军; 季旭彪


    BACKGROUND:Major complication after total hip replacement was instability in the form of dislocation. The probability of above complications has a great relationship with the mistakes of the angle of acetabular cup prosthesis. OBJECTIVE:To explore the influence of angle of acetabular cup in total hip replacement on the safety of joint flexion and extension. METHODS: A total of 60 patients, who underwent total hip replacement in the Wujin Hospital Affiliated to Jiangsu University from January 2012 to December 2014, were enroled in this study. Three dimensional directional monitoring device, CT scanning and image processing tools were used to preset the angle of the acetabular cup and to set abduction angle and anteversion angle. Test data were recorded and subjected to statistical analysis. RESULTS AND CONCLUSION:Acetabular cup was implanted under five different conditions: abduction angle 45°, anteversion angle 15°; abduction angle 60°, anteversion angle 15°; abduction angle 30°, anteversion angle 15°; abduction angle 45°, anteversion angle 5°; abduction angle 45°, anteversion angle 25°. According to statistics, in the patients with anteversion angle of 15°, when the acetabular cup was placed, the bigger the abduction angle, the bigger the range of abduction angle of the acetabular cup induced by pelvic tilt was. If the anteversion angle increased, the anteversion angle of the acetabular cup was reduced. With the increased pelvic tilt angle, the anteversion angle of the acetabular cup was big. Moreover, in patients with anteversion angle of 15°, the anteversion angle of the acetabular cup should keep consistent. When the abduction angle of the acetabular cup increased, the range of anteversion angle of the acetabular cup induced by pelvic tilt was diminished. These data showed that the abduction angle and anteversion angle of the acetabular cup have mutual restriction. When the acetabular cup was placed, big anteversion angle (15±10)° can wrap the

  8. Validation of a simple radiographic method to determine variations in pelvic and acetabular cup sagittal plane alignment after total hip arthroplasty

    Shon, Won Yong; Hur, Chang Yong; Jajodia, Nirmal [Korea University College of Medicine, Guro Hospital, Department of Orthopedics, Seoul (Korea); Gupta, Siddhartha; Biswal, Sandeep; Hong, Suk Joo; Myung, Jae Sung [Korea University College of Medicine, Guro Hospital, Department of Radiology, Seoul (Korea)


    Orientation of acetabular component, influenced by pelvic tilt, body position, and individual variations affects the outcome following total hip arthroplasty (THA). Currently available methods of evaluation are either imprecise or require advanced image processing. We analyzed intersubject and intrasubject variability of pelvic tilt, measured by sagittal sacral tilt (ST) and its relationship with acetabular component tilt (AT) by using a simple method based on standard radiographs. ST was measured on lateral radiographs of pelvis including lumbosacral spine obtained in supine, sitting, standing, and lateral decubitus position for 40 asymptomatic THA patients and compared to computed tomography (CT) data obtained in supine position. AT was measured on lateral radiographs (measured acetabular tilt: MAT) in each position and compared to measurement of AT on CT and an indirectly calculated AT (CAT). Mean ST changed from supine to sitting, standing, and lateral decubitus positions as follows: 26.5 {+-} 15.5 (range 4.6-73.4 ), 8.4{+-}6.2 (range 0.6-24.5 ), and 13.4{+-}8.4 (range 0.1-24.2 ; p<0.0001, p=0.002, p=0.006). The MAT on radiographs was not significantly different from the MAT measured on CT (p=0.002) and the CAT (p=0.06). There is a good correlation between change in ST and MAT in sagittal plane (r=0.93). Measurement of ST on radiographs is a simple and reliable method to track changes in pelvic tilt in different body positions. There is significant intersubject and intrasubject variation of ST and MAT with postural changes and it may explain causes of impingement or instability following THA, which could not be previously explained. (orig.)

  9. 非骨水泥型臼杯位置对植入假体髋臼内应力分布的影响%Changes of load distribution on cup-bone interface at the different positions of non-cemented acetabular cup

    李冬松; 李叔强; 齐欣; 刘建国


    BACKGROUND:Acetabular cup orientation is critical for preserving the range of motion and preventing dislocation of the prosthesis. Cup malpositioning may result in an increased polyethylene wear rate,pelvic osteolysis and acetabular migration (aseptic loosening).There are no definite criterion for the orientation of the acetabular cup.OBJECTIVE:To explore the relationship between acetabular cup Position and the load distribution within the acetabulum and to confirm an optimal range of cup position.thereby providing a theoretical criterion from a biomechanical aspect for proper cup implantation in clinical work.DESIGN:Repeated measurements.SETTING:Second Department of Orthopaedics in the First Clinical Hospital of Jilin University.MATERIALS: One healthy male adult fresh Cadaveric pelvis was offered by the Department of Anatomy in Jilin University.METHODS:This experiment was carried out at the Institute of Orthopaedics in the First Clinical Hospital of Jilin University,and the Institute of Biomechanics in Jilin University from September 2005 to May 2006.Cadaveric pelvic was scanned with spiral CT,and then the two-dimensional images were evaluated using GE medical systems software and the outline of the pelvis was identified by the edge detective estimation.Pelvic coordinate data were put into the computer to build up a three-dimensional (3D) finite element model of the pelvic using Solidworks software.A P48 non-cemented cup from Tianjin Huabei Medical Instrument Factory was used,and the 3D measurement of the cup was carried out by CLY single-arm 3D measurement apparatus,which was made in Testing Technology Institute of China.The measurement data were transferred into computer.Through the CAD SliodWorks2003 software,the 3D model of the cup was automatically reconstructed. Afterwards, one-foot standing position was simulated to conduct the loading and constraint of the model,the Mises and shear force distributing of the cup were analyzed,forecasting the mechanical risk

  10. Transfer of metallic debris from the metal surface of an acetabular cup to artificial femoral heads by scraping: comparison between alumina and cobalt-chrome heads.

    Chang, Chong Bum; Yoo, Jeong Joon; Song, Won Seok; Kim, Deug Joong; Koo, Kyung-Hoi; Kim, Hee Joong


    We aimed to investigate the transfer of metal to both ceramic (alumina) and metal (cobalt-chrome) heads that were scraped by a titanium alloy surface under different load conditions. The ceramic and metal heads for total hip arthroplasties were scraped by an acetabular metal shell under various loads using a creep tester. Microstructural changes in the scraped area were visualized with a scanning electron microscope, and chemical element changes were assessed using an energy dispersive X-ray spectrometry. Changes in the roughness of the scraped surface were evaluated by a three-dimensional surface profiling system. Metal transfer to the ceramic and metal heads began to be detectable at a 10 kg load, which could be exerted by one-handed force. The surface roughness values significantly increased with increasing test loads in both heads. When the contact force increased, scratching of the head surface occurred in addition to the transfer of metal. The results documented that metallic debris was transferred from the titanium alloy acetabular shell to both ceramic and metal heads by minor scraping. This study suggests that the greatest possible effort should be made to protect femoral heads, regardless of material, from contact with metallic surfaces during total hip arthroplasty.

  11. Coralline hydroxyapatite in complex acetabular reconstruction.

    Wasielewski, Ray C; Sheridan, Kate C; Lubbers, Melissa A


    This retrospective study examined whether a coralline hydroxyapatite bone graft substitute adequately repaired bone defects during complex acetabular reconstructions. Seventeen patients who underwent acetabular revision using Pro Osteon 500 were assessed to determine whether any cups required re-revision, whether bone had incorporated into the coralline hydroxyapatite grafts, and whether the coralline hydroxyapatite grafts resorbed with time. At latest follow-up, no cups required re-revision, but 1 had failed. Radiographic evidence of bone incorporation was observed in every coralline hydroxyapatite graft. Graft resorption was not observed.

  12. [Acetabular fractures].

    Gänsslen, A; Oestern, H J


    Treatment of acetabular fractures requires extensive knowledge of the bony anatomy, the amount of possible exposure of the bone with the selected approaches and fracture type-dependent indications of operative treatment. Classification of the fracture with detailed analysis of the fracture morphology is the basis for decision making and planning. The primary treatment aim is the anatomic reconstruction of the acetabulum which results in optimal long-term results.The basis of this overview is the presentation of standard treatment concepts in acetabular fracture surgery. Beside characteristics of the acetabular bony anatomy, biomechanical and pathomechanical principles and the relevant radiological anatomy, the treatment options, both conservative and operative and basic principles of the indications for standard surgical approaches will be discussed.The special fracture type is discussed in detail regarding incidence, injury mechanism, concomitant injuries, options for conservative and operative treatment, quality of operative reduction and long-term results.Furthermore, epidemiological data on typical postoperative complications are evaluated.

  13. CT evaluation of acetabular dysplasta in adults.


    Objective: To evaluate methods of measurement by CT and their clinical significance for acetabular dysplasia(AD) in adults. Methods: CT imaging was examined and measured in 33 adult patients with AD, compared with the normal control group of 210 adults. Results: This study showed the results of AD patients

  14. Optimization of acetabular component orientation using DOE

    Krepelka, Mircea; Toth-Taşcǎu, Mirela


    Stress shielding is increasingly recognized as an important cause of acetabular component failure. Several studies have been focused on improving the acetabular component placement to reduce the risk of dislocation, impingement and range of motion but little is known of its influence on implant-bone interface pressures. This study employs experimental design, 3D reconstruction and FE simulation to identify the most significant factors for acetabular component behavior and predict the best configuration of acetabular spatial orientation angles within the constraints of the Lewinnek's safe zone in order to minimize peak contact pressures. Data analysis by response surface method revealed that the magnitude of periacetabular pressures was significantly reduced by the anteversion angle at its lowest value as well as the abduction angle located at the central point value, which corresponded to a 40° abduction and 5° anteversion of cup orientation.

  15. Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

    De-Yong Huang; Liang Zhang; Yi-Xin Zhou; Chun-Yu Zhang; Hui Xu; Yong Huang


    Background:Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures,and good results have been reported with the use of these cups;however,the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear.This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures.Methods:A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012.Among these patients,two were lost to follow-up.Therefore,39 patients (39 hips) were finally included in this study.The Harris hip score before and after the surgery,satisfaction level of the patients,and radiographic results were assessed.Results:The mean Harris hip score increased from 34 (range,8-52) before surgery to 91 (range,22-100) at the latest follow-up examination (P < 0.001).The results were excellent for 28 hips,good for six,fair for three,and poor for two.Among the 39 patients,25 (64%) and 10 (26%) were very satisfied and somewhat satisfied,respectively.All cups were found to be fully incorporated,and no evidence of cup migration or periacetabular osteolysis was noted.Conclusions:Despite the technically demanding nature of the procedure,THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures.

  16. Periacetabular rotational osteotomy through the medial wall of ilium for the treatment of acetabu-lar dysplasia%经髂骨内侧壁髋臼周围旋转截骨治疗髋臼发育不良

    薛源; 冯香; 高化富; 张印峰


    Objective To investigate the effect of periacetabular rotational osteotomy through the medial wall of ilium on acetabular dysplasia. Methods Thirty-six patients with acetabular dysplasia were operated with periacetabular rotational osteotomy through medial wall of ilium. Firstly,the dissec-tion was performed in the subperiosteal plane of the medial ilium via the ilioinguinal incision to expose the medial wall of the bottom of acetabulum. Secondly,without dissecting the internal iliac vasculoneural sheaths,osteotome was used to complete the osteotomy around the acetabulum within 1. 5 cm. The supe-rior portion was greater sciatic notch and the inferior portion was pecten pubis and body of ischium. In or-der to isolate the acetabulum,the two layer cortical bone was cut through and without damaging the later-al periosteum. Thirdly,with the help of biofix rods,the acetabulum was rotated anterolaterally and inferi-orly to correct the Sharp angle to 35° and to restore the coverage rate of femoral head to 75% . Two stein-mann pins were used to put pressure on the medial wall of the bottom of acetabulum through anterior su-perior spine. Postoperatively,none of the operated patients was immobilized. Results Thirty-one of the total 36 patients had 7 to 82 months(average 22 months)of follow up. According to Mckay criteria,the effect was excellent in 21 cases and good in 8 cases. Conclusions Periacetabular rotational osteotomy through the medial wall of ilium for the treatment of acetabular dysplasia is an effective,simple method. It has the advantages of little influence on the stability of pelvis,reliable fixation without external fixa-tion,and can avoide the risk of complications. This method can not only alleviate the patients’pain in the injured hip,but also avoid or delay the development of osteoarthritis.%目的:探讨经髂骨内侧壁髋臼周围旋转截骨术治疗髋臼发育不良的疗效。方法应用经髂骨内侧壁髋臼周围旋转截骨术

  17. Comparison of one-dimensional and two-dimensional functionally graded materials for the backing shell of the cemented acetabular cup.

    Hedia, H S


    Among the factors that have been suggested as contributing to the failure of a total joint replacement are stress shielding and the subsequent bone resorption. Recent studies have shown that when a backing shell made from a Ti alloy is used, high stresses are generated in the cement at the edges of the cup, and low stresses are generated at the dome of the bone in the acetabulum; thus, the bone at the dome suffers stress shielding and the cement edge suffers high stresses. The aim of this study was to investigate the effect of using a functionally graded material (FGM), instead of Ti alloy, for the backing shell (BS) on the stress distribution in the BS-cement-bone system. Finite-element and optimization techniques were used to obtain the optimal distribution of materials in the tangential direction only of the backing (1D FGM) as well as in the tangential and radial directions of the backing (2D FGM). It was found that the stress distribution in the BS-cement-bone system was about the same, regardless of whether the BS was fabricated from a 1D or 2D FGM. The stress-shielding factor in the bone at the dome of the acetabulum and the maximum von Mises stress in cement at the cement interfaces for 1D and 2D FGM were reduced by about 51%, 69%, and 50%, respectively, compared to the case when the shell was fabricated from a Ti alloy. The optimal elastic modulus of the 1D FGM was obtained with the materials graded from HA at the dome of the acetabulum to a Ti alloy at the rim of the shell. The optimal elastic modulus of the 2D FGM was obtained with the materials graded from Ti alloy at the right edge of the rim, to Bioglass 45S5 at the left edge of the rim, and to HA at the dome of the shell.

  18. Influence of hip dysplasia on the development of osteoarthritis of the hip

    A.M. Lievense (Annet); S.M. Bierma-Zeinstra (Sita); A.P. Verhagen (Arianne); J.A.N. Verhaar (Jan); B.W. Koes (Bart)


    textabstractBACKGROUND: It has been suggested that in some patients with primary hip osteoarthritis (OA), the disease occurs as a consequence of acetabular dysplasia or hip dysplasia (HD). OBJECTIVE: To carry out a systematic review to investigate the association between acetabular

  19. Kidney Dysplasia

    ... Disease Ectopic Kidney Medullary Sponge Kidney Kidney Dysplasia Kidney Dysplasia What is kidney dysplasia? Kidney dysplasia is a condition in which ... Kidney dysplasia in one kidney What are the kidneys and what do they do? The kidneys are ...

  20. Total Hip Arthroplasty for The Treatment of End-stage Acetabular Dysplasia%全髋关节置换术治疗晚期髋臼发育不良

    李宇俊; 文立成; 曹永平; 杨昕


    Objective To explore the installing methods of hip prothesis in a total hip arthroplasty for patients of osteoarthritis secondary to end-stage acetabular dysplasia. Methods Between January 2002 and January 2008.a total of 60 hips in 52 patients with advanced osteoarthritis secondary to acetabular dysplasia underwent the total hip arthroplasty and were followed up. Among the patients,6 were male and 46 were female,with their ages ranging from 46 to 72 years and a average age of 62 years. The bilateral arthroplasty was performed in 8 patients and the unilateral arthroplasty in 44 patients. The main symptoms were pain and claudication. According to the developmental degree of acetabulums,three methods were adopted to perform the total hip arthroplasty,which were deepen acetabulum,inward deepening acetabulum and bone transplantation on external upper lip of acetabulum. The Harris scores were applied to evaluate function of the hip during follow-up. X-ray films for both joints were taken in order to learn the coalescence of acetablum with its bone bed after 3,6,9,12 months and every 1 years after operation. The follow-up time ranged from 2 years to 8 years,with an average of 4 years and 6 months. Results At the end of follow-up,the acetabulum prostheses contacted well with their beds of 45 years and the recovery of joint function was satisfactory and no sign of aseptic loosening among the cases of deepen acetabulum and inward deepened acetabulum. However,in 5 of 6 acetabulums which implanted bone on their external upper lip,there was a radiolucency between the implanted bone and the acetabulum prothesis after 2 years of the operation. No sign of aseptic loosening was found. Conclusion While performing total hip arthroplasty,various methods should be adopted according to the bed of acetabulum for the joints of osteoarthrosis due to acetabulum dysplasis. For the patient of enough bone at the bottom of acetabulum bed the acetabulum should be installed by the operation

  1. 经改良Smith-Peterson入路行Bernese髋臼周围截骨治疗成人髋臼发育不良%A modified smith-peterson approach to bernese periacetabular osteotomy for congenital acetabular dysplasia

    倪喆; 尚希福; 吴科荣; 胡飞


    Objective To examine the feasibility of a modified Smith-Peterson approach to the Bernese periacetabular osteotomy for Congenital Acetabular Dysplasia of adults and analyze the short-term clinical effect.Methods Totally 21 patients with 23 hips underwent the Bernese periacetabular osteotomy with a modified Smith-Peterson approach from July 2011 to June 2013 were adopted in this study. They included 5 males (5 hips) and 16 females (18 hips), aged 18 to 48 years old with a mean of 32.7. The blood loss and operation duration were recorded. The CE angle and Tonnis angle were evaluated radiographically pre-and post-operation, as well as progressed Harris Score.Results The coverage of the femoral head was enhanced post-operation in all patients. The time of the operation was (93±21) min and the bleeding volume was (550±135)ml. Significant improvement was seen radiographically with regard to the lateral CE angle which changed from 7.52°±4.67° to 30.26°±2.65°, anterior CE angle from 9.39°±3.04° to 25.52°±3.44°, and Tonnis angle from 22.36°± 6.79° to 7.28°±4.08°. All patients were followed-up in one year post-operation, Harris score was improved from 75.45±6.28 to 95.93±3.19. No nonunion of bone osteotomy and nerve injury were founded.Conclusion The modified Smith-Peterson approach to Bernese periacetabular osteotomy for congenital acetabular dysplasia is effective and safe. The outcomes is satisfy.%目的 研究改良Smith-Peterson入路在伯尔尼截骨治疗成人髋臼发育不良的可行性,并探讨其短期临床疗效.方法 自2011年7月到2013年6月,采用改良Smith-Peterson入路行Bernese髋臼截骨共治疗髋臼发育不良患者共21例23髋.其中男5例5髋,女16例18髋;年龄18~48岁,平均32.7岁.记录手术时间及术中出血量,测量术前、术后髋臼的CE角和Tonnis角,并对髋关节功能行Harris评分.结果 所有患者髋臼周围截骨术后股骨头覆盖均得到改善,手术时间为(93±21)min

  2. 大臼杯在髋臼骨缺损患者的髋关节翻修术中的应用%Application of jumbo cups for acetabular deficiencies in hip revision procedures used in acetabulum defects of the hip revision procedures

    王北岳; 周利武; 张志强; 郭亭; 赵建宁


    Objective To investigate the application of jumbo acetabular cups for Paprosky type II and type III A acetabular deifciencies after total hip arthroplasty ( THA ).Methods The clinical data of 24 patients who were diagnosed as acetabular deifciencies of Paprosky type II or type III A after THA from March 2007 to May 2014 were retrospectively analyzed. There were 13 males and 11 females, whose average age was 61.46 years old ( range: 34-77 years ). As to the reason of acetabular revision, there were 21 cases caused by aseptic loosening, 2 cases by habitual hip dislocation and 1 case by low toxicity infection. Primary and unilateral revision was performed on all the patients. Cemented acetabular prostheses were used in 11 cases, cementless acetabular prostheses in 10 cases and artiifcaial femoral head arthrolasty in 3 cases. According to the Paprosky acetabular defect classiifcation, there were 7 hips of type II A, 6 hips of type II B, 5 hips of type II C and 6 hips of type III A. Jumbo acetabular cups or combined with bone grafts were used in acetabular revision with prostheses. For the patients with acetabular deifciencies of Paprosky type II, the acetabulum was reamed and enlarged on the premise that the stability of the prosthesis was not affected, and then morselized bone graft was performed or the acetabular prosthesis with a jumbo cup was directly put in. For the patients with acetabular deifciencies of Paprosky type III A, an appropriate amount of compacted and morselized bone graft was used. Structural bone graft or the acetabular notch sealing was carried out, so as to increase the bone mass. The implantation technique through the center of the high ball could be directly adopted, with jumbo acetabular cups embedded. The problems of the balance of both lower limbs and the eccentricity could be handled by adjusting the length of the prosthetic handle and neck. A regular follow-up was carried out after the operation. The Harris hip score and Visual Analogue

  3. The computer assisted design of the custom prosthesis for acetabular dysplasia%成人髋臼发育不良的个性化股骨假体设计

    刘国强; 白波; 孙辉; 廖壮文


    目的 探讨个性化股骨假体计算机辅助设计在成人髋臼发育不良(AD)行全髋关节置换术中的应用.方法 取1例AD女性患者的髋关节和股骨全长CT扫描数据,直接以Dicom格式导入Mimics 10.01矢量化处理后建立股骨三维模型,提取股骨髓腔轮廓并重组三维模型.上述模型通过Solid Work 2005完成假体的优化处理.最后利用Mimics平台装载STL功能以及手术模拟模块完成假体虚拟植入.结果 实现了基于CT二维资料的三维重建,设计的假体与患者股骨髓腔匹配良好,通过模拟假体良好装配帮助解决假体前倾角调整,髓腔匹配等一系列问题.结论 以现代CT扫描所获得的二维影像资料在Mimics的矢量化处理后能获得精确的股骨三维模型;提取股骨髓腔并重建模型方便准确,与计算机辅助设计软件相结合可以设计出个性化股骨假体.%Objective To explore the application of The computer assisted design of the custom prosthesis in total hip replacement for Acetabular Dysplasia(AD).Methods Imported the Dicom images of volunteer's femur of AD into the Mimics 10.01 to build the 3D model. Extracted the sketch of cavity of femur and rebuild the 3D model. Exported the model into the Solid Work 2005 to design the custom prosthesis and saved it as the STL file. Loaded the STL file in Mimics 10.01 and completed the virtual implantation.Results Get the 3D model based on the CT images. The custom made prosthesis matched well with the cavity of femur. Figured out the question of femoral neck anteversion through the simulated implantation of custom prosthesis.Conclusions The 3D model was precise base on the Mimics software. The method of extracting the sketch of femur was convenient and comfortable. It was a feasible way of custom prosthesis design and providing a wide prospective.

  4. Loosening After Acetabular Revision

    Beckmann, Nicholas A.; Weiss, Stefan; Klotz, Matthias C.M.;


    The best method of revision acetabular arthroplasty remains unclear. Consequently, we reviewed the literature on the treatment of revision acetabular arthroplasty using revision rings (1541 cases; mean follow-up (FU) 5.7 years) and Trabecular Metal, or TM, implants (1959 cases; mean FU 3.7 years)...

  5. Copas de metal trabecular y aloinjertos óseos impactados en defectos acetabulares graves. Resultados a los 2-4 años. [Impacted bone allografts and trabecular metal cups in severe acetabular bone defects: 2 to 4-year results.

    Martín Buttaro


    Full Text Available In­tro­duc­ción: El objetivo principal es presentar la supervivencia del componente acetabular en pacientes con defectos graves reconstruidos con copas de metal trabecular combinadas con aloinjertos óseos impactados. Como objetivo secundario, se compararon estos resultados con los previamente obtenidos por los autores en defectos de similar gravedad utilizando anillos de reconstrucción y aloinjertos óseos. Materiales­ y­ Métodos:­ Se realizaron 20 cirugías de revisión en 19 pacientes (edad promedio 65 años, controlados, de forma prospectiva, con defectos acetabulares graves tipos 3A o 3B de Paprosky, por falla mecánica o infecciosa. El puntaje funcional promedio preoperatorio fue de 6,2 puntos, según la escala de Merle D ́Aubigne. Siempre se utilizaron copas de metal trabecular y aloinjertos óseos impactados. Resultados:­ A los 30 meses de seguimiento promedio (rango 24-48 meses, la supervivencia del componente acetabular fue del 95% (IC = 75%-98%. Un paciente presentó un aflojamiento acetabular por infección profunda a las 16 semanas de la revisión y fue tratado con una artroplastia de resección. El puntaje funcional promedio, excluido el caso con aflojamiento posoperatorio, fue de 16,2 puntos. Se observó la incorporación de los aloinjertos óseos en todos los pacientes, salvo el caso con infección profunda. La comparación con nuestras series históricas reconstruidas con anillos de Kerboull o con anillos GAP arrojó resultados altamente favorables a favor de las copas de metal trabecular.  Conclusiones: Las copas de metal trabecular asociadas a aloinjertos óseos impactados ofrecen una alternativa válida en cirugía de revisión acetabular con defectos graves del capital óseo. Este método se asocia a resultados más favorables que los obtenidos antes con anillos de reconstrucción.

  6. The cup safe-zone and optimum combination of the acetabular and femoral anteversions that fulfills the desired range of motion of the hip%满足日常生活活动范围的髋臼假体角度安全范围及杯颈前倾角组合

    李永奖; 蔡春元; 张力成; 杨国敬; 周德彪; 彭茂秀; 陈文良; 赵章伟


    Objective:To investigate safe range of acetabular prosthesis angle and the optimum combination of cup and neck in the range of activities of daily living (ADL). Methods: A three-dimensional generic parametric and kinematic simulation module of THA was developed. Range of motion (ROM) of flexion 3≥110°, internal-rotation ≥30° at 90° flexion, extension ≥30° and external rotation ≥40° were defined as the normal criteria for desired ROM for activities of daily living(ADL) ,and ROM of flexion ≥120°, internal-rotation ≥45° at 90° flexion,extension ≥30° and external rotation ≥40° as the severe criteria. The range of the changes in the general head-neck ratios (GR), the femoral neck anteversion (FA), the operative antever-sion (OA) and operative inclination (OI) of the cup component were 2-2.92,0°-30° ,0°-70°, 10°-60°respectively. For the collodiaphyseal angle(CCD) of 135°,the corresponding OA related to the 01 which every 5° was calculated,and described using dots and lines in a coordinate system in which OI of acetabular cup was the horizontal ordinate and OA of acetabular cup was the vertical ordinate. All data was analyzed by SAS 6.12 software. Results:Large GR greatly increased the size of safe range and it was recommended that GR be more than 2.37 when the CCD-angle was 135° as it further increases the size of safe-zone. The size of cup safety range of the severe criteria was smaller than normal criteria. When the CCD-angle was 135°, the optimum relationship between OA of acetabular and FA of the normal criteria and the severe criteria can be estimated by the formula:Y1=-0.816x1+39.76 (R2=0.993),Y2=-0-873x2+47.04 (R2=0.999) respectively. Conclusion:Large GR greatly increases the size of safe-zone and it is recommended that GR be more than 2.37, so it extends the acceptable range of error that clinicians cannot avoid it completely. The larger range of the hip motion, the smaller size of the cup safe-zone, but can retrieve by

  7. Cup-cage construct for acute fractures of the acetabulum, re-defining indications.

    Chana-Rodríguez, Francisco; Villanueva-Martínez, Manuel; Rojo-Manaute, Jose; Sanz-Ruíz, Pablo; Vaquero-Martín, Javier


    Acetabular fractures in the elderly are challenging injuries. The use of a trabecular metal acetabular cage was investigated as the treatment option in a series of elderly patients with acetabular fractures. At a 2-year follow up, 6 elderly patients were found to have mimimum pain, increased function, and increased scores using the Merle d'Aubigné and Postel system modified by Charnley. Radiographically, the areas of morsellised autograft that surrounded the cups were seen to have incorporated uniformly well, and the acetabular fractures were healed within six months after surgery. No mechanical failure, screw breakage, loosening, or migration was noticed. This novel indication of the cup-cage construction that uses revision techniques, for selected patients and fractures, to achieve an acute stable reconstruction, should be considered as an alternative reconstruction option in elderly patients presenting with acetabular fractures.

  8. Massive acetabular bone loss: Limits of trabecular metal cages

    Villanueva-Martínez Manuel


    Full Text Available Massive acetabular bone loss (more than 50% of the acetabular area can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage.

  9. High-precision measurements of cementless acetabular components using model-based RSA: an experimental study

    Baad-Hansen, Thomas; Kold, Søren; Kaptein, Bart L;


    BACKGROUND: In RSA, tantalum markers attached to metal-backed acetabular cups are often difficult to detect on stereo radiographs due to the high density of the metal shell. This results in occlusion of the prosthesis markers and may lead to inconclusive migration results. Within the last few yea...

  10. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    Brennan, S A


    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  11. Early results of the use of oblong S-ROM cementless acetabular component

    Popović Zoran


    Full Text Available Massive deficiency of acetabular bone stock is a challenging problem in the increasing number of patients who need a revision of the failed hip arthroplasty. Oblong acetabular cup has been presented as an alternative reconstruction technique for hips with extensive acetabular bone loss. The aim of this study was to present our results with the use of a bilobed acetabular component inserted during revisional surgery, to define indications, and to introduce this method into our orthopaedic practice. Seven patients underwent revisional hip arthroplasty with a cementless oblong acetabular component between September 2000 and June 2002. Six patients underwent revisional hip arthroplasty, and in one primary hip arthroplasty by oblong acetabular component was performed because of bone defect of acetabulum after gunshot fracture. The average follow up was thirteen months. Radiographic analysis in all patients demonstrated stable bone incorporated acetabular component with the restored hip. All the patients walked with full weight bearing and were without pain. On the basis of our experience we find this method statisfactory in certain types of bone defefects of acetabulum, and that it provides stable reconstruction of acetabulum with the correction of hip joint.

  12. Operative strategy of acetabular fractures

    WANG Yan; TANG Pei-fu; HUANG Peng


    Anatomic structure of acetabular fractures are complex and operative exposure and fixation are extremely difficult.For those obviously displaced acetabular fractures, close reduction is doomed to cause deformative healing. Open reduction with internal fixation (ORIF) not only results in anatomic reduction, but also brings complications. No matter which method will be adopted, traumatic arthritis or avascular necrosis of femoral head might occur. In order to treat acetabular fractures more effectively, orthopedic surgeons should be required to fully master the acetabular anatomy, biomechanics, classification and the necessary knowledge for complication prevention.

  13. The cup safe-zone and optimum combination of the acetabular and femoral anteversions in total hip arthroplasty%全髋关节置换术中髋臼假体位相的安全范围及杯颈前倾角的优化组合

    李永奖; 蔡春元; 张力成; 杨国敬; 林瑞新; 余斌峰; 吴立军


    Objective To determine the cup safe-zone and the optimum combination of cup and neck anteversions in total hip arthroplasty(THA). Methods A three-dimensional generic parametric and kinematic simulation module of THA was developed.Ordinary and strict criteria were defined regarding hip ROM as follows:normal criteria:flexion ≥ 110°,intorsion ≥ 30° at 90° flexion,backward extension ≥ 30°and extorsion ≥40° at the neutral position without prosthetic impingement; strict criteria:flexion ≥ 120°,intorsion≥45°at 90° flexion,backward extension ≥30° and extoraion ≥40° at the neutral position without prosthetic impingement.The changes in die head-neck ratio (GR),die femoral neck anteversion (F.A),the operative inclination (OI) and anteversion(OA) of the cup component ranged respectively from 2.00 to 2.92,0 to 30°,10° to 60° and 0 to 70°.For the 2 collodiaphyseal angles(CCD) of 130° and 135°,the corresponding OA related to the OI at every 5° was calculated. Results The size of cup safe-zone by the strict criteria is smaller than that by the normal criteria,and the sizes are both increased when a larger GR is chosen.When the CCD-angle is 130°,the optimum relationships between acetabular OA and FA by the normal and strict criteria can be estimated with the formula: Y1 =-0.840X1 + 38.41 and Y2 =-1.007X2 +47.46 respectively. The minimum allowable operative inclination (O1min) of the acetabulum should be more than 168.13 GR1-2.504 and 213.79 GR2-2.272 respectively.When the CCD changes from 135° to 130°,the cup safe-zone moves to an arca of a smaller OA and shrinks slightly in area. Conclusions Although the more strict the criteria regarding hip ROM,the smaller the cup safe-zone,the reduced safe-zone can be retrieved by increasing the GR.The OImin is largely reduced with an increasing GR The OA is negatively associated with the FA.Increase in neck anteversion and decrease in CCD can move the cup safe-zone towards an area of a smaller OA.%目的

  14. Early total hip arthroplasty for severe displaced acetabular fractures

    YANG Shu-hua; ZHANG Yu-kun; XU Wei-hua; LI Jin; LIU Guo-hui; YANG Cao; LIU Yong; TIAN Hong-tao


    Objective : To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.Methods: Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).Results: At the final follow-up the Harris hip score averaged 82(69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.Conclusions: In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

  15. Ectodermal dysplasia

    ... the womb. Alternative Names Anhidrotic ectodermal dysplasia; Christ-Siemens-Touraine syndrome Images Skin layers References Grange DK. Ectodermal dysplasias. Rimoin D, Korf B, eds. In: Emery and Rimoin's Principles and Practice of Medical Genetics . 6th ed. Philadelphia, PA: Elsevier; 2013:chap ...

  16. Pelvic orientation and assessment of hip dysplasia in adults

    Jacobsen, Steffen; Sonne-Holm, Stig; Lund, B;


    BACKGROUND: The study was performed to qualify the source material of 4151 pelvic radiographs for the research into the relationship between unrecognised childhood hip disorders and the development of hip osteoarthrosis, and to investigate the effect of varying degrees of pelvic tilt and rotation...... on the measurements of radiographic indices of hip dysplasia. MATERIAL AND METHODS: We investigated the effect of varying pelvic orientation on radiographic measurements of acetabular dysplasia using a cadaver model. Results from the cadaver study were used to validate the radiographic assessments of acetabular...... dysplasia in the longitudinal survey cohort of the Copenhagen City Heart Study (CCHS; Osteoarthrosis Sub-study). 1) Cadaver pelvises and proximal femurs from a male and a female donor were mounted anatomically in holding devices allowing independent inclination/reclination and rotation. An AP pelvic...

  17. Results of following-up for 5-10 years of periacetabular osteotomy for acetabular dysplasia in adolescence%伯尔尼髋臼周围截骨术治疗青少年髋关节发育不良5~10年随访结果

    张建立; 冯超; 尤海峰; 王玉琨


    of clinical follow-up was 88.5 (60-136) months.The mean Harris hip score increased from 89 ± 6 preoperatively to 97 ± 3 at the time of the most recent follow-up (t =-6.754,P =0.000).All patients (12 hips) had an excellent clinical result.The lateral center-edge angle of Wiberg increased from 4° ± 13° preoperatively to 36° ± 7° at the time of the most recent follow-up (t =-11.677,P =0.000).The acetabular roof obliquity decreased from 28° ± 10° preoperatively to 2° ± 8° at the time of the most recent follow-up (t =9.038,P =0.000).The acetabular-head index increased from 54% ± 11% preoperatively to 89% ± 13% at the time of the most recent follow-up (t =-11.137,P =0.000).The hip center was translated medially.Improvement of cystic degeneration of the acetabulum were found in 4 hips.Remodeling of aspherical uncongruence were found in 5 cases.Crossing sign were found in 2 hips postoperatively without symptoms of impingement.Conclusions PAO can provide comprehensive deformity correction and improve hip function in treatment of developmental dysplasia of the hip in adolescence.Some of the patients have improvement of cystic degeneration and remodeling of the hip.

  18. Periacetabular Osteotomy in patients with Hip Dysplasia investigated with Imaging Modalities

    Mechlenburg, Inger


    density correlates with postoperative migration of the osteotomised acetabular fragment measured with radiostereometric analysis. Chapter 5 explores the same cohort of patients with MRI and examines how many patients had acetabular or femoral head cysts and investigates whether the volume......” The Short Form-36 and Beighton questionnaires are collected to investigate the health-related QoL for patients with hip dysplasia operated with PAO and to investigate whether QoL is associated with the acetabular angles or hypermobility. In chapter 10, the fourth research question is investigated “Does...

  19. Late fiber metal shedding of the first and second-generation Harris Galante acetabular component. A report of 5 cases.

    Mayman, David J; González Della Valle, Alejandro; Lambert, Edward; Anderson, John; Wright, Timothy; Nestor, Bryan; Sculco, Thomas P; Salvati, Eduardo A


    Five patients presented with fiber metal mesh shedding of a Harris Galante II acetabular cup detected between 11 and 15 years after implantation. All patients presented with hip pain and 4 demonstrated gross acetabular loosening and fiber metal separation on preoperative radiographs. The remaining patient underwent revision surgery because of a liner dislodgment and had a radiographically well fixed shell. Loosening and fiber metal separation were detected intraoperatively. Scanning electron microscopy of the retrieved shells demonstrated isolated diffusion bonding marks in the areas where the mesh separated from the substrate and no evidence of corrosion. Progressive osteolysis in the iliac bone was evident in 4 of our cases. Progressive iliac osteolysis may lead to loss of bone support in well-fixed cups and excessive stresses transferred to the interface between the fiber metal mesh and the titanium substrate leading to the separation of the 2 layers. Fiber metal separation may contribute to long-term loosening in the Harris Galante acetabular component.

  20. Evaluating the accuracy of wear formulae for acetabular cup liners.

    Wu, James Shih-Shyn; Hsu, Shu-Ling; Chen, Jian-Horng


    This study proposes two methods for exploring the wear volume of a worn liner. The first method is a numerical method, in which SolidWorks software is used to create models of the worn out regions of liners at various wear directions and depths. The second method is an experimental one, in which a machining center is used to mill polyoxymethylene to manufacture worn and unworn liner models, then the volumes of the models are measured. The results show that the SolidWorks software is a good tool for presenting the wear pattern and volume of a worn liner. The formula provided by Ilchmann is the most suitable for computing liner volume loss, but is not accurate enough. This study suggests that a more accurate wear formula is required. This is crucial for accurate evaluation of the performance of hip components implanted in patients, as well as for designing new hip components.

  1. Radiographic and clinical analysis of cementless acetabular fixation in total hip arthroplasty

    ZHANG Hui; PEI Fu-xing; YANG Jing; SHEN Bin; SHI Rui


    Objective: To investigate the factors affecting the fixation, loosening and therapeutic effect of cementless acetabular prosthesis through following up the patients with total hip arthroplasty clinically and radiographically.Methods: From February 1998 to May 1999, 139 patients (148 hips) underwent total hip arthroplasty with cementless acetabular prosthesis in our department. In this study, the clinical therapeutic effect and the anteroposterior radiographs of the pelvis and anteroposterior and lateral radiographs of the hips of 109 patients (116 hips) made before operation, at 1 week, 3, 6, and 12 months after operation and annually thereafter were analyzed retrospectively. The clinical therapeutic effects were evaluated with Harris hip score. Radiographs were used to observe the position of prostheses and the bone changes around the implant, and to measure the wearing speed and direction of the acetabular cup. All evaluations were made by an independent examiner who did not participate in the operation. The patients were followed up for 5-6 years.Results: The mean Harris score was 44 points (range, 10-70 points) before operation, but it increased to 92.4 points (range, 80-100 points) at the latest review after operation, which was significantly higher than that before operation (P<0.05). No acetabular component was revised because of infection or aseptic loosening. And no acetabular component migrated. There was no revision of fixed acetabular component because of pelvic osteolysis secondary to polyethylene wear. The mean linear wear rate was 0.15 mm per year. All the acetabular prostheses were classified as stable on the radiographs.Conclusions: In terms of fixation, total hip arthroplasty with cementless acetabular components was successful. Although there is no aseptic loosening and a low incidence of osteolysis at the latest follow-up evaluation, polyethylene wear cannot be avoided and can lead to expansile osteolysis near the cups. This kind of osteolysis

  2. Ectodermal dysplasia

    Sonia Saggoo


    Full Text Available Hereditary hypohidrotic ectodermal dysplasia, also called the Christ-Siemens-Touraine Syndrome is characterized by congenital dysplasia of one or more ectodermal structures and is manifested by hypohidrosis, hypotrichosis and hypodontia. It is usually an X-linked recessive mendelian character which is rarely seen in males. It results from abnormal morphogenesis of cutaneous and oral embryonic ectoderm. Patients with this disorder exhibit smooth , thin and dry skin, fine and blond scanty hair. Intra-orally anodontia or hypodontia, with impaired development of alveolar process is seen. A case report of a rare case of this disorder in a female patient aged 18 years is hereby presented.

  3. Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

    Christophe Boulay


    Full Text Available Acetabular cup orientation (inclination and anteversion is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter could determine the safe range of pelvis tilt (positional parameter for an individual and not a group.

  4. Design optimization of cementless metal-backed cup prostheses using the concept of functionally graded material.

    Hedia, H S; El-Midany, T T; Shabara, M A N; Fouda, N


    Metal backing has been widely used in acetabular cup design. A stiff backing for a polyethylene liner was initially believed to be mechanically favourable. Yet, recent studies of the load transfer around acetabular cups have shown that a stiff backing causes two problems. It generates higher stress peaks around the acetabular rim than those caused by full polyethylene cups and reduces the stresses transferred to the dome of the acetabulum causing stress shielding. The aim of this study is to overcome these two problems by improving the design of cementless metal-backed acetabular cups using the two-dimensional functionally graded material (FGM) concept through finite-element analysis and optimization techniques. It is found that the optimal 2D FGM model must have three bioactive materials of hydroxyapatite, Bioglass and collagen. This optimal material reduces the stress shielding at the dome of the acetabulum by 40% and 37% compared with stainless steel and titanium metal backing shells, respectively. In addition, using the 2D FGM model reduces the maximum interface shear stress in the bone by 31% compared to the titanium metal backing shell.

  5. Design optimization of cementless metal-backed cup prostheses using the concept of functionally graded material

    Hedia, H S; El-Midany, T T; Shabara, M A N; Fouda, N [Production Engineering and M/C Design Department, Faculty of Engineering, Mansoura University, Mansoura (Egypt)


    Metal backing has been widely used in acetabular cup design. A stiff backing for a polyethylene liner was initially believed to be mechanically favourable. Yet, recent studies of the load transfer around acetabular cups have shown that a stiff backing causes two problems. It generates higher stress peaks around the acetabular rim than those caused by full polyethylene cups and reduces the stresses transferred to the dome of the acetabulum causing stress shielding. The aim of this study is to overcome these two problems by improving the design of cementless metal-backed acetabular cups using the two-dimensional functionally graded material (FGM) concept through finite-element analysis and optimization techniques. It is found that the optimal 2D FGM model must have three bioactive materials of hydroxyapatite, Bioglass and collagen. This optimal material reduces the stress shielding at the dome of the acetabulum by 40% and 37% compared with stainless steel and titanium metal backing shells, respectively. In addition, using the 2D FGM model reduces the maximum interface shear stress in the bone by 31% compared to the titanium metal backing shell.

  6. Options for acetabular fixation surfaces.

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K


    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  7. Assessment of adult hip dysplasia and the outcome of surgical treatment

    Troelsen, Anders


    Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist...... pelvic positioning during assessment of hip deformities because pelvic tilt affects the appearance of acetabular version. Weight-bearing assessment of acetabular version showed the presence of retroversion in 33% of dysplastic hips. The establishment of retroversion as a rather frequent entity...... magnetic resonance arthrography remains the gold standard. PERIACETABULAR OSTEOTOMY FOR SURGICAL TREATMENT OF HIP DYSPLASIA IN ADULTS: Encouraging hip joint survival and clinical outcome were reported at medium-term follow-up after periacetabular osteotomy. The small number of studies reporting the outcome...

  8. An unusual mode of failure of a tripolar constrained acetabular liner: a case report.

    Banks, Louisa N


    Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient\\'s weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.

  9. Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

    Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)


    While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

  10. Assessment of hip dysplasia and osteoarthritis: Variability of different methods

    Troelsen, Anders; Elmengaard, Brian; Soeballe, Kjeld (Orthopedic Research Unit, Univ. Hospital of Aarhus, Aarhus (Denmark)), e-mail:; Roemer, Lone (Dept. of Radiology, Univ. Hospital of Aarhus, Aarhus (Denmark)); Kring, Soeren (Dept. of Orthopedic Surgery, Aabenraa Hospital, Aabenraa (Denmark))


    Background: Reliable assessment of hip dysplasia and osteoarthritis is crucial in young adults who may benefit from joint-preserving surgery. Purpose: To investigate the variability of different methods for diagnostic assessment of hip dysplasia and osteoarthritis. Material and Methods: By each of four observers, two assessments were done by vision and two by angle construction. For both methods, the intra- and interobserver variability of center-edge and acetabular index angle assessment were analyzed. The observers' ability to diagnose hip dysplasia and osteoarthritis were assessed. All measures were compared to those made on computed tomography scan. Results: Intra- and interobserver variability of angle assessment was less when angles were drawn compared with assessment by vision, and the observers' ability to diagnose hip dysplasia improved when angles were drawn. Assessment of osteoarthritis in general showed poor agreement with findings on computed tomography scan. Conclusion: We recommend that angles always should be drawn for assessment of hip dysplasia on pelvic radiographs. Given the inherent variability of diagnostic assessment of hip dysplasia, a computed tomography scan could be considered in patients with relevant hip symptoms and a center-edge angle between 20 deg and 30 deg. Osteoarthritis should be assessed by measuring the joint space width or by classifying the Toennis grade as either 0-1 or 2-3

  11. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Vasileios Sakellariou


    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  12. Oculodentodigital dysplasia

    Dharmil C Doshi


    Full Text Available Oculodentodigital dysplasia is a rare, autosomal dominant disorder with high penetrance and variable expressivity, caused by mutations in the connexin 43 or gap junction protein alpha-1 gene. It has been diagnosed in fewer than 300 people worldwide with an incidence of around 1 in 10 million. It affects many parts of the body, particularly eyes (oculo, teeth (dento, and fingers and/or toes (digital. The common clinical features include facial dysmorphism with thin nose, microphthalmia, syndactyly, tooth anomalies such as enamel hypoplasia, anodontia, microdontia, early tooth loss and conductive deafness. Other less common features are abnormalities of the skin and its appendages, such as brittle nails, sparse hair, and neurological abnormalities. To prevent this syndrome from being overlooked, awareness of possible symptoms is necessary. Early recognition can prevent blindness, dental problems and learning disabilities. Described here is the case of a 21-year-old male who presented to the ophthalmology outpatient department with a complaint of bilateral progressive loss of vision since childhood.

  13. CT classification of acetabular fractures

    Marincek, B.; Porcellini, B.; Robotti, G.


    The contribution of computed tomography (CT) in classifying acetabular fractures was analysed retrospectively in 33 cases. CT and plain radiography classification agreed in 27 cases (82%). CT revealed more extensive fractures in 6 patients (thereof 5 patients with associated fractures). In 10 patients (thereof 9 patients with associated fractures) CT showed intraarticular fragments; radiographically intraarticular fragments were seen only in 2 patients and suspected in 4. CT is of considerable aid in defining the fracture pattern. It should be used mainly in patients with radiographically difficult interpretable associated fractures in order to assess preoperatively the weight-bearing part of the acetabulum, the degree of displacement and the presence of intraarticular fragments.

  14. Clinical and radiological outcome of the cemented Contemporary acetabular component in patients < 50 years of age.

    Schmitz, M W J L; Timmer, C; Rijnen, W H C; Gardeniers, J W M; Schreurs, B W


    Despite the worldwide usage of the cemented Contemporary acetabular component (Stryker), no published data are available regarding its use in patients aged Contemporary acetabular component with the Exeter cemented stem between January 1999 and January 2006. There were 152 hips in 126 patients, 61 men and 65 women, mean age at surgery 37.6 years (16 to 49 yrs). One patient was lost to follow-up. Mean clinical follow-up of all implants was 7.6 years (0.9 to 12.0). All clinical questionnaire scores, including Harris hip score, Oxford hip score and several visual analogue scales, were found to have improved. The eight year survivorship of all acetabular components for the endpoints revision for any reason or revision for aseptic loosening was 94.4% (95% confidence interval (CI) 89.2 to 97.2) and 96.4% (95% CI 91.6 to 98.5), respectively. Radiological follow-up was complete for 146 implants. The eight year survival for the endpoint radiological loosening was 93.1% (95% CI 86.2 to 96.6). Three surviving implants were considered radiologically loose but were asymptomatic. The presence of acetabular osteolysis (n = 17, 11.8%) and radiolucent lines (n = 20, 13.9%) in the 144 surviving cups indicates a need for continued observation in the second decade of follow-up in order to observe their influence on long-term survival. The clinical and radiological data resulting in a ten-year survival rate > 90% in young patients support the use of the Contemporary acetabular component in this specific patient group.

  15. An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

    Reza Tavakoli Darestani


    Full Text Available Introduction: Acetabular fractures are a common problem among young males. An acetabular fracture with disruption of the joint surface, if untreated, will rapidly lead to post-traumatic osteoarthritis. Proper reduction and internal fixation depend on accurate classification and the quality of imaging.Case Presentation: We present an unusual form of acetabular fracture, which is not included in the conventional classification (Judet and Letournel ; this occurred in a middle-aged male who was operatively treated without any complications. In this case due to posterior extension of the fracture into the SI joint and concomitant anterior column fracture in the area above the acetabular dome, no portion of the acetabular anterior surface remained connected to the innominate bone.Conclusions: We recognized this type of fracture and treated it similarly to both column fractures. We recommend that the classification of acetabular fractures be modified to include this type of fracture.

  16. Fibromuscular dysplasia

    Jeunemaitre Xavier


    Full Text Available Abstract Fibromuscular dysplasia (FMD, formerly called fibromuscular fibroplasia, is a group of nonatherosclerotic, noninflammatory arterial diseases that most commonly involve the renal and carotid arteries. The prevalence of symptomatic renal artery FMD is about 4/1000 and the prevalence of cervicocranial FMD is probably half that. Histological classification discriminates three main subtypes, intimal, medial and perimedial, which may be associated in a single patient. Angiographic classification includes the multifocal type, with multiple stenoses and the 'string-of-beads' appearance that is related to medial FMD, and tubular and focal types, which are not clearly related to specific histological lesions. Renovascular hypertension is the most common manifestation of renal artery FMD. Multifocal stenoses with the 'string-of-beads' appearance are observed at angiography in more than 80% of cases, mostly in women aged between 30 and 50 years; they generally involve the middle and distal two-thirds of the main renal artery and in some case also renal artery branches. Cervicocranial FMD can be complicated by dissection with headache, Horner's syndrome or stroke, or can be associated with intracerebral aneurysms with a risk of subarachnoid or intracerebral hemorrhage. The etiology of FMD is unknown, although various hormonal and mechanical factors have been suggested. Subclinical lesions are found at arterial sites distant from the stenotic arteries, and this suggests that FMD is a systemic arterial disease. It appears to be familial in 10% of cases. Noninvasive diagnostic tests include, in increasing order of accuracy, ultrasonography, magnetic resonance angiography and computed tomography angiography. The gold standard for diagnosing FMD is catheter angiography, but this invasive procedure is only used for patients in whom it is clinically pertinent to proceed with revascularization during the same procedure. Differential diagnosis include

  17. Primary total hip arthroplasty for acetabular fracture

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying


    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  18. Acetabular roof arc angles and anatomic biomechanical superior acetabular weight bearing area

    Thossart Harnroongroj


    Full Text Available Background: Acetabular fracture involves whether superior articular weight bearing area and stability of the hip are assessed by acetabular roof arc angles comprising medial, anterior and posterior. Many previous studies, based on clinical, biomechanics and anatomic superior articular surface of acetabulum showed different degrees of the angles. Anatomic biomechanical superior acetabular weight bearing area (ABSAWBA of the femoral head can be identified as radiographic subchondral bone density at superior acetabular dome. The fracture passes through ABSAWBA creating traumatic hip arthritis. Therefore, acetabular roof arc angles of ABSAWBA were studied in order to find out that the most appropriate degrees of recommended acetabular roof arc angles in the previous studies had no ABSAWBA involvement. Materials and Methods: ABSAWBA of femoral head was identified 68 acetabular fractures and 13 isolated pelvic fractures without unstable pelvic ring injury were enrolled. Acetabular roof arc angle was measured on anteroposterior, obturator and iliac oblique view radiographs of normal contralateral acetabulum using programmatic automation controller digital system and measurement tools. Results: Average medial, anterior and posterior acetabular roof arc angles of the ABSAWBA of 94 normal acetabulum were 39.09 (7.41, 42.49 (8.15 and 55.26 (10.08 degrees, respectively. Conclusions: Less than 39°, 42° and 55° of medial, anterior and posterior acetabular roof arc angles involve ABSAWBA of the femoral head. Application of the study results showed that 45°, 45° and 62° from the previous studies are the most appropriate medial, anterior and posterior acetabular roof arc angles without involvement of the ABSAWBA respectively.


    G. M. Kavalersky


    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

  20. Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults

    Troelsen, Anders


    adults with symptomatic hip dysplasia. The surgical aim of this extensive procedure is to reorient the acetabulum to improve coverage and eliminate the pathological hip joint mechanics. Intraoperative assessment of the achieved acetabular reorientation is therefore crucial. The "classic" surgical......Hip dysplasia is characterized by an excessively oblique and shallow acetabulum with insufficient coverage of the femoral head. It is a known cause of pain and the development of early osteoarthritis in young adults. The periacetabular osteotomy is the joint-preserving treatment of choice in young...

  1. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun


    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  2. Cross-sectional Anatomy of Ilium for Guiding Acetabular Component Placement Using High Hip Center Technique in Asian Population

    Jian-Lin Xiao; Jian-Lin Zuo; Peng Liu; Yan-Guo Qin; Xue-Zhou Li; Tong Liu; Zhong-Li Gao


    Background:Many clinical studies have been published involving the use of a high hip center (HHC),achieved good follow-up.However,there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium.The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC.Methods:A total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study.After importing the data to the mimics software,we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis,then we measured the thickness and width of the ilium for each cross section in axial plane,calculated the cup coverage at each chosen section.Results:At the acetabular dome,the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm,respectively,whereas at 1 cm above the dome,decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively,and 2 cm above the dome,decreased to 31.25 ± 4.04 and 26.65 ± 3.43,respectively.Acetabular cup averaged coverage for 40-,50-,and 60-mm hemispheric shells,was 100%,89%,and 44% at the acetabular dome,100%,43.7%,and 27.5% for 1 cm above the dome,and 37.5%,21.9%,and 14.2% for 2 cm above the dome.Conclusions:HHC reconstructions within l cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better.

  3. Three-Cup Chicken


    Ingredents:500 grams chicken legs,100 grams(about one tea cup)rice wine,50 grams(a small tea cup)sesame oil,50grams refined soy sauce,25 grams white sugar,10grams oyster sauce,chopped scallions,ginger root,garlic,and some hot chili peppers

  4. Rotary cup slurry atomization

    Sommer, H. T.; Marnicio, R. J.


    The theory of a two-phase flow in a rotating cup atomizer is described. The analysis considers the separation of the solid and liquid media thus realistically modeling the flow of two layers along the inner cup wall: a slurry of increasing solids concentration and a supernatent liquid layer. The analysis is based on the earlier work of Hinze and Milborn (1950) which addressed the flow within a rotary cup for a homogeneous liquid. The superimposition of a settling velocity under conditions of high centrifugal acceleration permits the extended analysis of the separation of the two phases. Appropriate boundary conditions have been applied to the film's free surface and the cup wall and to match the flow characteristics at the liquid-slurry interface. The changing slurry viscosity, increasing nonlinearly with growing solid loading, was also considered. A parameter study illustrates the potential for a cup design to provide optimal slurry and liquid film thicknesses for effective atomization.

  5. Genetics Home Reference: metatropic dysplasia

    ... damage the spinal cord; either a sunken chest (pectus excavatum) or a protruding chest (pectus carinatum); and joint ... Disease InfoSearch: Metatrophic dysplasia MalaCards: metatropic dysplasia Nemours Children's Health System Orphanet: Metatropic dysplasia Patient Support and ...

  6. Cervical dysplasia - series (image)

    ... to detect cervical cancer. Limited or early cervical cancer (carcinoma in situ, or cervical intraepithelial neoplasia, or dysplasia) requires treatment with ablation therapy, usually in the form of ...

  7. Explicit finite element modelling of the impaction of metal press-fit acetabular components.

    Hothi, H S; Busfield, J J C; Shelton, J C


    Metal press-fit cups and shells are widely used in hip resurfacing and total hip replacement procedures. These acetabular components are inserted into a reamed acetabula cavity by either impacting their inner polar surface (shells) or outer rim (cups). Two-dimensional explicit dynamics axisymmetric finite element models were developed to simulate these impaction methods. Greater impact velocities were needed to insert the components when the interference fit was increased; a minimum velocity of 2 m/s was required to fully seat a component with a 2 mm interference between the bone and outer diameter. Changing the component material from cobalt-chromium to titanium alloy resulted in a reduction in the number of impacts on the pole to seat it from 14 to nine. Of greatest significance, it was found that locking a rigid cap to the cup or shell rim resulted in up to nine fewer impactions being necessary to seat it than impacting directly on the polar surface or using a cap free from the rim of the component, as is the case with many commercial resurfacing cup impaction devices currently used. This is important to impactor design and could make insertion easier and also reduce acetabula bone damage.

  8. A comparative study of "plasmacup" and "porous-coated" acetabular components: survival after 10 to 12 years of follow-up

    José Ricardo Negreiros Vicente


    Full Text Available OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1 absence of radiolucent lines, (2 presence of a superolateral buttress, (3 medial stress-shielding, (4 radial trabeculae, and (5 an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4% with a PCA versus nine (12.3% with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful

  9. Surgical treatment for complicated acetabular fractures

    Ning An; Yang Yanmin


    Objective: To sum up the surgical approaches and clinical outcome of complicated acetabular fractures. Methods: 17 patients with complicated acetabular fractures (including 4 cases of transverse with posterior wall fractures, 7 cases of posterior column and wall fractures, 4 cases of anterior and posterior columns fractures, 1 cases of T-type fracture and 1 cases of anterior column with posterior hemitransverse fractures) underwent open reduction and internal fixation with screws and plates by Kocher-Langenbeck (8 cases), ilio-inguinal (2 cases), extended iliofemoral (4 cases) or ilio-inguinal combined with K-L approaches (3 cases). Results: 12 patients with anatomical reduction, 4 patients with satisfactory reduction and 1 patient with non-satisfactory reduction. 15 out of 17 cases were followed up for 6 months to 5 years, and the excellent and good rate was 70.5%. Conclusion: Surgical treatment for complicated acetabular fractures can get a satisfactory reduction and a good clinical outcome.

  10. Radiological findings for hip dysplasia at skeletal maturity. Validation of digital and manual measurement techniques

    Engesaeter, Ingvild Oevsteboe [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Haukeland University Hospital, The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Bergen (Norway); Laborie, Lene Bjerke; Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Lehmann, Trude Gundersen; Fevang, Jonas; Engesaeter, Lars Birger [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Sera, Francesco [University College London Institute of Child Health, Medical Research Council Centre of Epidemiology for Child Health, London (United Kingdom); Pedersen, Douglas; Morcuende, Jose [University of Iowa Hospital and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, IA (United States); Lie, Stein Atle [Uni Health, Uni Research, Bergen (Norway)


    To report on intra-observer, inter-observer, and inter-method reliability and agreement for radiological measurements used in the diagnosis of hip dysplasia at skeletal maturity, as obtained by a manual and a digital measurement technique. Pelvic radiographs from 95 participants (56 females) in a follow-up hip study of 18- to 19-year-old patients were included. Eleven radiological measurements relevant for hip dysplasia (Sharp's, Wiberg's, and Ogata's angles; acetabular roof angle of Toennis; articulo-trochanteric distance; acetabular depth-width ratio; femoral head extrusion index; maximum teardrop width; and the joint space width in three different locations) were validated. Three observers measured the radiographs using both a digital measurement program and manually in AgfaWeb1000. Inter-method and inter- and intra-observer agreement were analyzed using the mean differences between the readings/readers, establishing the 95% limits of agreement. We also calculated the minimum detectable change and the intra-class correlation coefficient. Large variations among different radiological measurements were demonstrated. However, the variation was not related to the use of either the manual or digital measurement technique. For measurements with greater absolute values (Sharp's angle, femoral head extrusion index, and acetabular depth-width ratio) the inter- and intra-observer and inter-method agreements were better as compared to measurements with lower absolute values (acetabular roof angle, teardrop and joint space width). The inter- and intra-observer variation differs notably across different radiological measurements relevant for hip dysplasia at skeletal maturity, a fact that should be taken into account in clinical practice. The agreement between the manual and digital methods is good. (orig.)

  11. Brazil World Cup Challenges

    MANSUR, R.


    Full Text Available Overcoming the productivity challenge is the main benefit of the 2014 World Cup for Brazilian people. The sustainable development of our cultural tourism industry will catapult the new middle class growing up rate.

  12. Polyethylene and metal debris generated by non-articulating surfaces of modular acetabular components.

    Huk, O L; Bansal, M; Betts, F; Rimnac, C M; Lieberman, J R; Huo, M H; Salvati, E A


    We report a prospective study of the liner-metal interfaces of modular uncemented acetabular components as sources of debris. We collected the pseudomembrane from the screw-cup junction and the empty screw holes of the metal backing of 19 acetabula after an average implantation of 22 months. Associated osteolytic lesions were separately collected in two cases. The back surfaces of the liners and the screws were examined for damage, and some liners were scanned by electron microscopy. The tissues were studied histologically and by atomic absorption spectrophotometry to measure titanium content. The pseudomembrane from the screw-cup junction contained polyethylene debris in seven specimens and metal debris in ten. The material from empty screw holes was necrotic tissue or dense fibroconnective tissue with a proliferative histiocytic infiltrate and foreign-body giant-cell reaction. It contained polyethylene debris in 14 cases and metal in five. The two acetabular osteolytic lesions also showed a foreign-body giant-cell reaction to particulate debris. The average titanium levels in pseudomembranes from the screw-cup junction and the empty screw holes were 959 micrograms/g (48 to 11,900) and 74 micrograms/g (0.72 to 331) respectively. The tissue from the two lytic lesions showed average titanium levels of 139 and 147 micrograms/g respectively. The back surfaces of the PE liners showed surface deformation, burnishing, and embedded metal debris. All 30 retrieved screws demonstrated fretting at the base of the head and on the proximal shaft. Non-articular modular junctions create new interfaces for the generation of particulate debris, which may cause granulomatous reaction.

  13. Comparison of Head Center Position and Screw Fixation Options Between a Jumbo Cup and an Offset Center of Rotation Cup in Revision Total Hip Arthroplasty: A Computer Simulation Study.

    Faizan, Ahmad; Black, Brandon J; Fay, Brian D; Heffernan, Christopher D; Ries, Michael D


    Jumbo acetabular cups are commonly used in revision total hip arthroplasty (THA). A straightforward reaming technique is used which is similar to primary THA. However, jumbo cups may also be associated with hip center elevation, limited screw fixation options, and anterior soft tissue impingement. A partially truncated hemispherical shell was designed with an offset center of rotation, thick superior rim, and beveled anterior and superior rims as an alternative to a conventional jumbo cup. A three dimensional computer simulation was used to assess head center position and safe screw trajectories. Results of this in vitro study indicate that a modified hemispherical implant geometry can reduce head center elevation while permitting favorable screw fixation trajectories into the pelvis in comparison to a conventional jumbo cup.

  14. Spondylo-costal dysplasia

    Kozlowski, K.


    Fourteen patients with spondylo-costal dysplasia were analysed. 3 of them presented without obvious associated anomalies ''pure'' spondylo-costal dysplasias; 2 had several components consistent with Vater (Vacterl)-Association; 2 showed malformations which are often encountered in Vater (Vacterl)-Association; 4 presented with minor malformations; 3 had major associated malformations rarely seen in Vater (Vacterl)-Association. Thoracic spine and costal malsegmentation can be sporadically observed in other ''errors in septation complex'' (axial mesodermal dysplasia) including severe myelomeningocoele and diastematomyelia.

  15. Influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations in total hip arthroplasty

    LI Yong-jiang; YANG Guo-jing; ZHANG Li-cheng; CAI Chun-yuan; WU Li-jun


    Objective: To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion (ROM) for activities of daily living in total hip arthroplasty (THA).Methods: Athree-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion≥ 120°, internal rotation ≥45° at 90° flexion, extension ≥30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck (CCD)-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios (GR=2, 2.17, 2.37, 2.61 and 2.92) and femoral anteversions (FA=0°, 10°, 20° and 30°).Results: Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR>2.37 could further increase the size of safe-zones. There was a complex interplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion (OA) and femoral antetorsion (FA) could be estimated by the formula: OA=-0.80×FA+47.06, andthe minimum allowable operative acetabular inclination (OImin) would be more than 210.5×GR-2.255.Conclusions: Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination (OI), surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients' individual situations

  16. Recognition of minor adult hip dysplasia: which anatomical indices are important?

    Pereira, Felipe; Giles, Andrew; Wood, Gavin; Board, Tim N


    The rise in popularity of hip arthroscopy has led to a renewed interest in mild hip dysplasia. There is a lack of clarity in the literature regarding both the diagnosis and management of such patients. The aim of this study was to analyse the relative importance of and the inter-relationship between the classically described anatomical indices of dysplasia.One hundred and fifty hips with varying degrees of hip dysplasia were studied. The following were measured: centre-edge (CE), Sharp's and Tönnis angles, acetabular head index (AHI), and acetabular index of depth to width (AIDW). Spearman's correlation coefficient was calculated.Using the CE angle 82 hips were classified as normal and 68 dysplastic. Of the 82 patients with a normal CE angle, 20-39% were dysplastic on at least one other variable. The CE angle did not have a significant correlation to other variables. The remaining four variables showed inter-correlations between 0.26 and 0.54. Overall the Tönnis angle showed the strongest correlation with the other variables. In the patient group with CE angles 21o to 25o (minor dysplasia) 72% of hips had Tönnis angles greater than 10o and 28% had angles greater than or equal to 15o indicating the great variability in the level of dysplasia within this group.In patients with mild dysplasia we have shown that measurement of a single anatomical variable may lead to under-diagnosis. We recommend the measurement the CE angle combined with at least one other variable and suggest the use of the Tönnis angle.

  17. Cervical deciduosis imitating dysplasia.

    van Diepen, Diederik Anthony; Hellebrekers, Bart; van Haaften, Anne-Marie; Natté, Remco


    Ectopic cervical deciduosis is generally an accidental finding during pregnancy, and usually presents without any symptoms or need for therapeutic intervention. However, it can sometimes imitate dysplasia or carcinoma. We report a case of a 34-year-old G2P0, with a history of cervical dysplasia, presenting at 11 weeks of gestation, with vaginal blood loss. During examination, lesions mimicking dysplasia were found on the cervix. Histological examination reported cervical deciduosis. Deciduosis is a benign change during pregnancy and will resolve spontaneously. With the increasing use of cytology and colposcopy, the reported incidence is growing. When it is hard to differentiate between dysplasia and deciduosis, histological confirmation should be considered.

  18. Gracile bone dysplasias

    Kozlowski, Kazimierz [Department of Medical Imaging, The Children' s Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW (Australia); Masel, John [Department of Radiology, Royal Children' s Hospital, Brisbane (Australia); Sillence, David O. [Department of Paediatrics and Child Health, The University of Sydney (Australia); Arbuckle, Susan [Department of Anatomical Pathology, The Children' s Hospital at Westmead, NSW (Australia); Juttnerova, Vera [Oddeleni Lekarske Genetiky, Hradec Kralove (Czech Republic)


    Gracile bone dysplasias constitute a group of disorders characterised by extremely slender bones with or without fractures. We report four newborns, two of whom showed multiple fractures. Two babies had osteocraniostenosis and one had features of oligohydramnios sequence. The diagnosis in the fourth newborn, which showed thin long bones and clavicles and extremely thin, poorly ossified ribs, is uncertain. Exact diagnosis of a gracile bone dysplasia is important for genetic counselling and medico-legal reasons. (orig.)

  19. Craniofacial fibrous dysplasia

    Aakarsh Jhamb


    Full Text Available Fibrous dysplasia can present clinically in varied forms which may appear as collision of different pathologic processes. We report a rare case of craniofacial fibrous dysplasia with coexisting epithelial lined cyst and superimposed osteomyelitis with sequestrum formation. Its clinical features and management with possible hypotheses are described along with the post operative course. Pertinent literature has been reviewed with emphasis on pathogenesis of this unique occurrence.

  20. Mandibulo-acral dysplasia

    Hoeffel, J.C.; Mainard, L. [Dept. of Radiology, Children' s Hospital, Vandoeuvre (France); Chastagner, P. [Dept. of Medicine, Children' s Hospital, Vandoeuvre (France); Hoeffel, C.C. [UFR Faculte de Medecine Cochin, Paris (France)


    We report on a 7 year-old-girl with mandibulo-acral dysplasia. When she was 3 years of age it mimicked scleroderma because of skin atrophy and later on a Hutchinson-Gilford progeria syndrome (HGP). Acro-mandibular dysplasia was diagnosed because of facial hypoplasia and mandibular hypoplasia. The bilateral proximal mid-humeral notch seen in this case is unusual. (orig.)

  1. Computed tomography analysis of acetabular anteversion and abduction

    Stem, Eric S. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); South Carolina Sports Medicine and Orthopaedic Center, North Charleston, SC (United States); O' Connor, Mary I. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); Kransdorf, Mark J. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Crook, Julia [Mayo Clinic, Biostatistic Unit, Jacksonville, FL (United States)


    The purpose of this study is to define the normal range of acetabular abduction and anteversion in relation to pelvic anatomy as depicted on conventional CT scan. We retrospectively reviewed 100 pelvic CT scans performed on patients presenting for evaluation of non-orthopaedic pathology. The study group consisted of 58 women and 42 men, aged between 18 and 88 years. Standard imaging protocol included an anteroposterior (AP) topogram with contiguous 5-mm thick axial images from the superior margin of the iliac crest to the lesser trochanter of the femur. The acetabular abduction was measured from the AP topogram by obtaining the angle between a line drawn from the acetabular teardrop to the lateral acetabular margin and a horizontal line between the ischial tuberosities. Acetabular anteversion was measured on axial images at the level of the mid-femoral head. We found the mean acetabular abduction to be 39 degrees (standard deviation 4 degrees, range 27 to 51 degrees) and the mean acetabular anteversion to be 23 degrees (standard deviation 5 degrees, range 12 to 39 degrees). Data suggests that acetabular anteversion may average 2.7 degrees lower in males than females and increase slightly with age, while abduction may tend to decrease with age. Ninety percent of patients had acetabular abduction between 31 and 46 degrees; the 90% central range for acetabular anteversion was estimated to be from 14 to 31 degrees. CT scanning is useful in accurately defining the normal range of acetabular abduction and antiversion. Knowledge of this normal anatomy will allow accurate assessment of acetabular component position as delineated on conventional CT scanning. (orig.)

  2. Computed tomography of the acetabular fractures

    Jung, Ho Young; Suh, Jin Suck; Park, Chang Yun; Lee, Kil Woo [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initial radiographs, we compared and analysed the computed tomographic findings and plain radiographic findings. The results were as follow: 1. In patients with multiple trauma, no further change in position was required during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plain radiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, and femoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments. 5. CT was helpful in detecting the associated fractures and soft tissue injuries. 6. CT also demonstrated the adequacy of reduction, the position of metallic fixation devices, and the presence or absence of remaining intraarticular osseous fragments after surgery.

  3. Complementary Coffee Cups

    Banchoff, Thomas


    What may have been the birth of a new calculus problem took place when the author noticed that two coffee cups, one convex and one concave, fit nicely together, and he wondered which held more coffee. The fact that their volumes were about equal led to the topic of this article: complementary surfaces of revolution with equal volumes.

  4. Compact rotating cup anemometer

    Wellman, J. B.


    Compact, collapsible rotating cup anemometer is used in remote locations where portability and durability are factors in the choice of equipment. This lightweight instrument has a low wind-velocity threshold, is capable of withstanding large mechanical shocks while in its stowed configuration, and has fast response to wind fluctuations.

  5. The perennial cup anemometer

    Kristensen, L.


    A short version of the history of the cup anemometer precedes a more technical discussion of the special features of this instrument. These include its extremely linear calibration and the non-linearity of its response to wind speed changes. A simple conceptual model by Schrenk is used to demonstrate this and to explain why the cup anemometer is able to start from a zero rotation rate at zero wind to one corresponding to a sudden change in the ambient wind speed to a finite value. The same model is used to show that the cup anemometer should be characterized by a distance constant rather than by a time constant. The bias in the measured mean wind speed due to the random variations in the three velocity components is discussed in terms of standard, semiquantitative turbulence models, and the main thesis is that this bias is overwhelmingly dominated by the fluctuations of the lateral wind velocity component, i.e. the wind component perpendicular to the mean wind direction, and not, as is often assumed, by the longitudinal wind velocity component. It is shown theoretically and tested experimentally that the bias due to lateral wind velocity fluctuations can be significantly reduced by means of a special data processing of the simultaneous signals from a cup anemometer and a wind vane. This means that, with care, the overall overspeeding can be reduced to less than 1%.

  6. 3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty

    Andrew J. Hughes


    Full Text Available Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice.

  7. 3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty

    DeBuitleir, Cathal; Soden, Philip; O'Donnchadha, Brian; Tansey, Anthony; Abdulkarim, Ali; McMahon, Colm; Hurson, Conor J.


    Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D) representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice. PMID:28168060

  8. Surgical treatment of displaced acetabular fractures

    Milenković Saša


    Full Text Available Introduction. Acetabular fractures are severe injuries, generally caused by high-energy trauma, most frequently from traffic accidents or falls from heights. Fractures of the extremities, head injuries, chest, abdomen and pelvic ring injuries are most commonly associated injuries. Objective. The purpose of this study was to evaluate the results of open reduction and internal fixation of acetabular fractures. The open anatomical reduction of the articular surface combined with a rigid internal fixation and early mobilisation have become the standard treatment of these injuries. Methods. We conducted a retrospective analysis of 22 patients of average age 43.13 years. The patients were treated by open reduction and internal fixation at the Orthopaedic Clinic of Niš from 2005-2009. The follow-up was 12 to 60 months, with the average of 21.18 months after surgery. Results. All injured patients were operated on between 4 and 11 days (5.7 days on the average. According to the classification by Judet and Letournel, 15 (68.18% patients had an elementary acetabular fracture, whereas 7 (31.82% patients had associated fracture. A satisfactory postoperative reduction implying less than 2 mm of displacement was achieved in 19 (86.36% patients. The radiological status of the hip joint, determined according to Matta score, was excellent in 15 (68.18% patients, good in 4 (18.18% patients and moderate in 3 (13.63% patients. According to Merle d’Aubigné Scale, the final functional results of the treatment of all operated patients were excellent in 12 (54.54% patients, good in 7 (31.81% patients and moderate in 3 (13.63% patients. Conclusion. Surgical treatment of dislocated acetabular fractures requires an open reduction and a stable internal fixation. Excellent and good results can be expected only if anatomical reduction and stable internal fixation are achieved.

  9. Plain film analysis of acetabular fracture

    Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan [Inje Medical College Paik Hospital, Pusan (Korea, Republic of)


    Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%)


    Iulian ICLEANU


    Full Text Available In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (genu valgum, the ankles (ankle valgus, calcaneal valgus and the spine (scoliosis especially at the lumbar level. The most spectacular are at the hip level, that is why we made an analytical evaluation only for this joint. To show the importance of physiotherapy for children with hip dysplasia we started from the hypothesis: untimely treatment for children with hip dysplasia has improved results in functional recovery and in obtaining a better stability, without the necessity of orthopedics or surgical interventions. The research methods used in this study are: the observation method, the bibliographic study method, the experimental method, the graphics method and the statistical mathematical method to process the data and to represent the results graphically. In the end, the results obtained are significantly different from the initial evaluations and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient improves stability and biomechanical parameters for the hip.

  11. Surgical treatment for complex acetabular fractures

    LIU Qiang; WU Dou; LI Ping; HAN Shu-feng


    Objective: To explore the effect of surgical treatment on complex acetabular fractures.Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years ) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8.Results: All the patients were followed up for 3.5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86 %.Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.

  12. Management of developmental dysplasia of the hip in less than 24 months old children

    Mehmet Bulut


    Full Text Available Background: There is no consensus on the treatment of developmental dysplasia of the hip in children less than 24 months of age. The aim of this study was to present the results of open reduction and concomitant primary soft-tissue intervention in patients with developmental dysplasia of the hip in children less than 24 months of age. Materials and Methods: Sixty hips of 50 patients (4 male, 46 female with mean age of 14.62 ± 5.88 (range 5-24 months months with a mean followup of 40.00 ± 6.22 (range 24-58 months months were included. Twenty five right and 35 left hips (10 bilaterally involved were operated. Open reduction was performed using the medial approach in patients aged < 20 months (with Tönnis type II-III and IV hip dysplasias and for those aged 20-24 months with Tönnis type II and III hip dysplasias ( n = 47. However for 13 patients aged 20-24 months with Tönnis type IV hip dysplasias, anterior bikini incision was used. Results: Mean acetabular index was 41.03 ± 3.78° (range 34°-50° in the preoperative period and 22.98 ± 3.01° (range 15°-32° at the final visits. Mean center-edge angle at the final visits was 22.85 ± 3.35° (18°-32°. Based on Severin radiological classification, 29 (48.3% were type I (very good, 25 (41.7% were type II (good and 6 (10% were type III (fair hips. According to the McKay clinical classification, postoperatively the hips were evaluated as excellent ( n = 42; 70%, good ( n = 14; 23.3% and fair ( n = 4; 6.7%. Reduction of all hip dislocations was achieved. Additional pelvic osteotomies were performed in 14 (23.3% hips for continued acetabular dysplasia and recurrent subluxation. (Salter [ n = 12]/Pemberton [ n = 2] osteotomy was performed. Avascular necrosis (AVN developed in 7 (11.7% hips. Conclusion: In DDH only soft-tissue procedures are not enough, because of the high rate of the secondary surgery and AVN for all cases aged less than 24 months. Bone procedures may be necessary in the walking


    傅明; 张志奇; 向珊珊; 刘进; 黄广鑫


    目的 通过生物力学测试,比较髋臼旋转截骨术及Chiari截骨术治疗成人发育性髋关节发育不良(developmental dysplasia of the hip,DDH)后对髋关节生物力学的影响.方法 取8具成年女性骨盆标本,切除双侧髋关节髋臼后沿和上沿,使其股骨头中心点垂线与髋臼外侧边缘夹角< 20°,制备DDH模型;然后于左侧行髋臼旋转截骨术,右侧行Chiari截骨术.分别对正常标本、DDH模型及两种截骨术后标本,于材料试验机上以5mm/min速率加载至600 N测量髋关节应变值.结果 正常标本左、右侧髋关节应变值分别为845.63±533.91及955.94±837.42; DDH模型应变值明显增加,左、右侧分别为1 439.03±625.23及1 558.75±1 009.46,约为正常标本的2倍.结合形态学、影像学检查,提示DDH模型制备成功.髋臼旋转截骨术后髋关节应变值为574.94±430.88,较DDH模型明显下降,差异有统计学意义(t=4.176,P=0.004).Chiari截骨术后髋关节应变值为1 614.81±932.67,与DDH模型相似,差异无统计学意义(t=0.208,P=0.841).髋臼旋转截骨术后髋关节应变值与术前应变值之差显著低于Chiari截骨术,差异有统计学意义(t=-2.548,P=0.023).结论 髋臼旋转截骨术缓解DDH髋关节病理性应力的效果优于Chiari截骨术.%Objective To evaluate the internal fixation effect, degradation, and biocompatibility of polylactic-co glycolic acid/hydroxyapatite (PLGNHA) absorbable cannulated screws in treatment of lateral femoral condyle fracture of canine so as to provide the theory basis for their further improvement and clinical application. Methods Sixteen adult male Beagles (weighing, 9-12 kg) were selected to prepare the models of bilateral lateral femoral condyle fracture; left fracture was fixed with PLGA/HA absorbable cannulated screws as experimental group and right fracture with metal screws as control group. At 2, 4, 8, and 12 weeks after operation, general observation was done and X-ray films ere

  14. Modified Faraday cup

    Elmer, John W.; Teruya, Alan T.; O'Brien, Dennis W.


    A tomographic technique for measuring the current density distribution in electron beams using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams. The modified Faraday cup includes a narrow slit and is rotated by a stepper motor and can be moved in the x, y and z directions. The beam is swept across the slit perpendicular thereto and controlled by deflection coils, and the slit rotated such that waveforms are taken every few degrees form to and the waveforms are recorded by a digitizing storage oscilloscope. Two-din-tensional and three-dimensional images of the current density distribution in the beam can be reconstructed by computer tomography from this information, providing quantitative information about the beam focus and alignment.

  15. Conservatively treated acetabular fractures: A retrospective analysis

    Narender Kumar Magu


    Full Text Available Background: There are a few studies reporting the long term outcome of conservatively treated acetabular fractures. The present study aims to evaluate the quality of reduction, and radiological and functional outcome in displaced acetabular fractures treated conservatively. Materials and Methods: Sixty-nine patients (55 men and 14 women with 71 displaced acetabular fractures (mean age 38.6 years managed conservatively were retrospectively evaluated. There were 11 posterior wall, 5 posterior column, 6 anterior column, 13 transverse, 2 posterior column with posterior wall, 9 transverse with posterior wall, 6 T-shaped, 1 anterior column with posterior hemi-transverse, and 18 both-column fractures. The follow-up radiographs were graded according to the criteria developed by Matta J. Functional outcome was assessed using Harris hip score and Merle d′Aubigne and Postel score at final followup. Average follow-up was 4.34 years (range 2-11 years. Results: Patients with congruent reduction (n=45 had good or excellent functional outcome. Radiologic outcome in incongruent reduction (n=26 was good or excellent in 6 and fair or poor in 20 hips. The functional outcome in patients with incongruent reduction was good or excellent in 16 and satisfactory or poor in 10 hips. Good to excellent radiologic and functional outcome was achieved in all patients with posterior wall fractures including four having more than 50% of broken wall. Good to excellent functional outcome was observed in 88.8% of both-column fractures with secondary congruence despite medial subluxation. Conclusions: Nonoperative treatment of acetabular fractures can give good radiological and functional outcome in congruent reduction. Posterior wall fractures with a congruous joint without subluxation on computed tomography axial section, posterior column, anterior column, infratectal transverse or T-shaped, and both-column fractures may be managed conservatively. Small osteochondral fragments

  16. The influence of acetabular inclination angle on the penetration of polyethylene and migration of the acetabular component: a prospective, radiostereometric study on cemented acetabular components.

    Kadar, T; Furnes, O; Aamodt, A; Indrekvam, K; Havelin, L I; Haugan, K; Espehaug, B; Hallan, G


    In this prospective study we studied the effect of the inclination angle of the acetabular component on polyethylene wear and component migration in cemented acetabular sockets using radiostereometric analysis. A total of 120 patients received either a cemented Reflection All-Poly ultra-high-molecular-weight polyethylene or a cemented Reflection All-Poly highly cross-linked polyethylene acetabular component, combined with either cobalt-chrome or Oxinium femoral heads. Femoral head penetration and migration of the acetabular component were assessed with repeated radiostereometric analysis for two years. The inclination angle was measured on a standard post-operative anteroposterior pelvic radiograph. Linear regression analysis was used to determine the relationship between the inclination angle and femoral head penetration and migration of the acetabular component. We found no relationship between the inclination angle and penetration of the femoral head at two years' follow-up (p = 0.9). Similarly, our data failed to reveal any statistically significant correlation between inclination angle and migration of these cemented acetabular components (p = 0.07 to p = 0.9).

  17. Field calibration of cup anemometers

    Schmidt Paulsen, Uwe; Mortensen, Niels Gylling; Hansen, Jens Carsten


    A field calibration method and results are described along with the experience gained with the method. The cup anemometers to be calibrated are mounted in a row on a 10-m high rig and calibrated in the free wind against a reference cup anemometer. The method has been reported [1] to improve...... the statistical bias on the data relative to calibrations carried out in a wind tunnel. The methodology is sufficiently accurate for calibration of cup anemometers used for wind resource assessments and provides a simple, reliable and cost-effective solution to cup anemometer calibration, especially suited...

  18. Management of ischemic deformity after the treatment of developmental dysplasia of the hip.

    Cech, Oldrich; Vávra, Jaroslav; Zídka, Michal


    Long-term results of 69 hip operations for deformities due to avascular necrosis following the conservative treatment of the hip dysplasia were evaluated. The authors' technique of intertrochanteric valgus osteotomy allows for simultaneously handling of varus deformity and shortening of the femoral neck, fusion of the greater trochanter, and correction of increased femoral anteversion, if necessary. This type of surgery was used in children with Buchholz-Ogden type III deformity starting from 3 years of age until adolescence. Patients were followed for an average of 19.3 years. Eighty-seven percent had no marked limitation in range of motion and 57% were free of complaints. Trendelenburg gait was present in only six patients. Radiographs of all patients showed improvement of coxometric values. Acetabular dysplasia was handled in 29 patients with a subsequent shelf arthroplasty. Total hip arthroplasty for hip degeneration was not indicated for any of the patients to date.

  19. World Cup television


    In the last year of the first decade of the 21st century, in the verge of breaking into the era of digital television, it is important to know what kind of television model is available in Portugal. The analysis of the news coverage of the FIFA 2010 World Cup will certainly help in finding the answers. In this article, we present a study that centers its focus on news formats related to this great media event, broadcasted in both generalist as well as cable news networks between the 11th of J...

  20. Double Cups with Phoenix


    THIS cup, unearthed at the site of an aristocrat’s tomb (No. 2 Baoshan Tomb) of the Chu State, was a vessel used during weddings in ancient times. According to the earliest account of the vessel, found in the book Liji, a new couple would use it to gargle together, which meant that they would be of one heart and one mind, and that they would love and take care of each other. Shaped like a standing phoenix, the vessel is 17.6 cm. long. The phoenix holds a pearl in its beak and its wings are spread

  1. Early results of revision acetabular cup using antiprotrusio reconstruction rings and allografts

    Krzysztof Kmiec


    Conclusion: A modified, antiprotrusion cage provides an acceptable survival rate and radiological results, but complications could still be expected. It seems that the observed massive bone loss with pelvic discontinuity and an insufficient fixation of the cage to the ischium may result in implant loosening. Stable fixation of the ischial ring flange with screws is an essential condition to expect a good outcome.

  2. Lumbar-sacral dysplasias

    Schumacher, M.; Thron, A.


    By means of some selected examples, the myelographic and CT characteristics are presentated of different lumbar-sacral dysplasias. The advantage of the different methods of examination (CT, CT myelography and myelography) and the improved presentation of pathological-anatomical details by means of a combination of these methods in the diagnosis of hyperplasia of the filum terminale, diastematomyelia, tethered conus, intracorporal and anterior sacral meningocele have been shown.

  3. Segmental odontomaxillary dysplasia: clinical, radiological and histological aspects of four cases

    Becktor, K.B.; Reibel, J.; Vedel, B.;


    Segmental odontomaxillary dysplasia, hemimaxillofacial dysplasia, histological and radiological findings......Segmental odontomaxillary dysplasia, hemimaxillofacial dysplasia, histological and radiological findings...

  4. [Craniofacial fibrous dysplasia].

    Couturier, A; Aumaître, O; Mom, T; Gilain, L; André, M


    Fibrous dysplasia of bone is a benign, uncommon, sporadic, congenital skeletal disorder resulting in deformity. This disease arises from activating somatic mutation in GNAS which encodes the α subunit of the G stimulatory protein associated with proliferation of undifferentiated osteogenic cells resulting in marrow fibrosis, abnormal matrix production, and stimulation of osteoclastic resorption upon overproduction of IL-6 observed in dysplastic cells. Fibrous dysplasia may be monostotic or polyostotic. This mutation affecting many tissues, café au lait skin macules and endocrinopathies (precocious puberty, hyperthyroidism, growth hormone excess, Cushing syndrome) may be associated in McCune-Albright syndrome, but also myxoma in Mazabraud syndrome or phosphate diabetes. Diagnosis of craniofacial fibrous dysplasia should be considered in the presence of headache, neuralgia, sensory disorders (vision, hearing, balance, smelling), functional disorders (nasal obstruction, nasolacrimal duct obstruction, non-matching occlusion), infectious complications (sinusitis, otitis, mastoiditis). Such symptoms should lead to perform craniofacial CT scan completed with MRI. Bone biopsy is not systematic. Surgical treatment is discussed in cases of nervous complication, facial deformity or active lesions. In case of pain resistant to conventional analgesics, intravenous bisphosphonates can be proposed. In non-responder patients, several case reports suggest the efficacy of a monoclonal antibody directed against the IL-6 receptor which requires to be confirmed by randomized studies.

  5. Alternative medicine: an update on cupping therapy.

    Chen, B; Li, M-Y; Liu, P-D; Guo, Y; Chen, Z-L


    To know the research progress of cupping therapy all over the world, the authors analyze the research of cupping therapy in recent 5 years. It indicates that cupping therapy can be applied to extensive curable disease, but has poor clinical evidence. Some improvements in the mechanism research of cupping therapy have been made, but it needs further research. The adverse events of cupping therapy attract attention. The standardization of cupping therapy has emerged.

  6. Cup Cylindrical Waveguide Antenna

    Acosta, Roberto J.; Darby, William G.; Kory, Carol L.; Lambert, Kevin M.; Breen, Daniel P.


    The cup cylindrical waveguide antenna (CCWA) is a short backfire microwave antenna capable of simultaneously supporting the transmission or reception of two distinct signals having opposite circular polarizations. Short backfire antennas are widely used in mobile/satellite communications, tracking, telemetry, and wireless local area networks because of their compactness and excellent radiation characteristics. A typical prior short backfire antenna contains a half-wavelength dipole excitation element for linear polarization or crossed half-wavelength dipole elements for circular polarization. In order to achieve simultaneous dual circular polarization, it would be necessary to integrate, into the antenna feed structure, a network of hybrid components, which would introduce significant losses. The CCWA embodies an alternate approach that entails relatively low losses and affords the additional advantage of compactness. The CCWA includes a circular cylindrical cup, a circular disk subreflector, and a circular waveguide that serves as the excitation element. The components that make it possible to obtain simultaneous dual circular polarization are integrated into the circular waveguide. These components are a sixpost polarizer and an orthomode transducer (OMT) with two orthogonal coaxial ports. The overall length of the OMT and polarizer (for the nominal middle design frequency of 2.25 GHz) is about 11 in. (approximately equal to 28 cm), whereas the length of a commercially available OMT and polarizer for the same frequency is about 32 in. (approximately equal to 81 cm).

  7. Algorithm for automatic angles measurement and screening for Developmental Dysplasia of the Hip (DDH).

    Al-Bashir, Areen K; Al-Abed, Mohammad; Abu Sharkh, Fayez M; Kordeya, Mohamed N; Rousan, Fadi M


    Developmental Dysplasia of the Hip (DDH) is a medical term represent the hip joint instability that appear mainly in infants. The examination for this condition can be done by ultrasound for children under 6 months old and by X-ray for children over 6 months old. Physician's assessment is based on certain angles derived from those images, namely the Acetabular Angle, and the Center Edge Angle. In this paper, we are presenting a novel, fully automatic algorithm for measuring the diagnostic angles of DDH from the X-ray images. Our algorithm consists of Automatic segmentation and extraction of anatomical landmarks from X-ray images. Both of Acetabular angle and Center edge angle are automatically calculated. The analysis included X-ray images for 16 children recruited for the purposed of this study. The automatically acquired angles accuracy for Acetabular Angle was around 85%, and an absolute deviation of 3.4°±3.3° compared to the physician's manually calculated angle. The results of this method are very promising for the future development of an automatic method for screening X-ray images DDH that complement and aid the physicians' manual methods.

  8. Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

    van der Veen, Hugo; van Jonbergen, H.P.W.; Poolman, R.W.; Bulstra, S.K.; van Raay, J.J.A.M.


    Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethyle

  9. Acetabular paralabral cyst: an uncommon cause of sciatica

    Sherman, P.M.; Sanders, T.G. [Department of Radiology, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236 (United States); Matchette, M.W. [University of Texas Medical School, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 (United States); Parsons, T.W. [Department of Orthopedic Surgery, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236 (United States)


    The association between tears of the acetabular labrum and paralabral cysts has been well documented, and magnetic resonance imaging (MRI) has been shown to be the most accurate noninvasive method of depicting not only the normal anatomic structures of the hip, but also the common pathologic processes such as labral tears and paralabral cysts. We present the case of an acetabular paralabral cyst that resulted in clinically symptomatic compression of the sciatic nerve. (orig.)

  10. Cup Anemometer Overspeeding

    Busch, N. E.; Kristensen, Leif


    Statistical considerations are applied to a general equation of motion for cup anemometers in a turbulent wind. It is shown that the relative overspeeding ΔS/S can be expressed as ΔS/S = Ih2 · Js(l0/Λs) + cIw2, where Is and Iw are the horizontal and the vertical turbulence intensifies, respectively....... The function Js depends on the shape of the spectrum of horizontal turbulent energy, l0 is the distance constant for the anemometer, and Λs is a characteristic length scale of the horizontal turbulence. The constant c is of order unity. If Λs is suitably chosen as the scale of the energy-containing eddies...

  11. Theoretical Implications of Periacetabular Osteotomy in Various Dysplastic Acetabular Cartilage Defects as Determined by Finite Element Analysis

    Xu, Meng; Qu, Wenrui; Wang, Yanbing; Zhong, Lei; Zhu, Zhe; Li, Wei; Zhao, Xin; Wang, Jincheng; Sun, Yu


    Background Different extents and locations of acetabular cartilage defect have been supposed to be a major cause of undesirable outcomes of periacetabular osteotomy (PAO) in patients with developmental dysplasia of the hip (DDH). This study aimed to verify whether different locations of cartilage deficiency affect the biomechanical environment in a three-dimensional model utilizing finite element analysis (FEA). Material/Methods We developed 3 DDH models – DDH-1 (normal shape), DDH-2 (superior defect), and DDH-3 (anterosuperior defect) – by deforming from a normal hip model. We also developed 3 PAO models – PAO-1, PAO-2, and PAO-3 – through rotating osteotomized fragments. Results The maximum von Mises stress in the normal hip was 13.06 MPa. In the DDH-1 model, the maximum value on the load-bearing area decreased from 15.49 MPa pre-PAO to 14.28 MPa post-PAO, while stresses in the DDH-2 and DDH-3 models were higher than in the DDH-1 model, both pre-PAO and post-PAO (30.46 MPa to 26.04 MPa for DDH-2; 33.89 MPa to 27.48 MPa for DDH-3). Conclusions This study shows that, both pre- and post-PAO, different types of cartilage deficiency affect the biomechanical environment. Furthermore, in dysplastic hips, obtaining accurate three-dimensional information about the acetabular cartilage can contribute substantially to PAO decision making. PMID:28017958

  12. Optic atrophy and glaucomatous cupping.

    Radius, R L; Maumenee, A E


    We reviewed 170 eyes of 112 patients with optic atrophy from various causes. Special attention was directed towards measured cup:disk ratios as well as presence of glaucomatous-like cupping of the optic nerve head. We observed a small but significant increase in nerve head cupping in eyes with optic atrophy when compared to contralateral eyes, as well as to eyes of 50 diabetic patients. No characteristic glaucomatous disk changes were documented. We evaluated these findings with respect to possible causes of glaucomatous disk and field changes.

  13. Prospective evaluation of clinical and radiographic outcomes of Pem-berton osteotomy in patients with developmental dysplasia of hip

    Saeid Tabatabai


    Full Text Available Background: Acetabular dysplasia is a well-known cause of early osteoarthritis of hip which may appear at any time (perinatal, breast-feeding and childhood. The aim of this study was to evaluate the clinical and radiographic outcomes of children with de-velopmental dysplasia of hip (DDH after undergoing open reduction, capsulorrhaphy and Pemberton osteotomy procedures. Methods: This study prospectively conducted on 13 patients with DDH who attended to Razi Hospital at Ahvaz Jundishapur University of Medical Sciences at Ahvaz, Iran, from April 2012 to March 2015. Inclusion criteria were children with age range of 18 months to 8 years and acetabular index≥ 40 degree. Exclusion criteria were the age less than 18 months or above 8 years, connective tissue diseases, secondary dislocation due to previous infection, and acetabular dysplasia with specific syndrome. All patients were evaluated before surgery and at least one year after surgery in terms of clinical evaluations, dislocation or subluxation of hip, congruity of hip and radiological out-comes according to grading systems of McKay, Tonnis grading system, Severin classi-fication and acetabular index, respectively. All patients underwent open reduction, capsulorrhaphy, and Pemberton’s osteotomy in single-stage surgery and if necessary femoral shortening was performed. Results: Ten patients (12 hips were evaluated. Of those, 4 patients (40% had right hip involvement. The mean age score was 38.92±12.37 months (range: 24-65 months. Acetabular index showed significant reduction after surgery in compare to before sur-gery (P= 0.002. According to Tonnis grading, 91.6% of cases were in I-II classes. Moreover, 66.6% of cases at clinical examinations of McKay criteria had excellent and good results after surgery. According to Severin radiographic findings criteria, 83.2% of cases were in I-III classes after surgery. There was statistically significant improvement in patients according to different

  14. Three-fin acetabular prosthesis for superior acetabular bone defects: a three-dimensional finite element analysis

    LIU Yu-zeng; HAI Yong; ZHAO Hui


    Background Given that three-dimensional finite element models have been successfully used to analyze biomechanics in orthopedics-related research,this study aimed to establish a finite element model of the pelvic bone and three-fin acetabular component and evaluate biomechanical changes in this model after implantation of a three-fin acetabular prosthesis in a superior segmental bone defect of the acetabulum.Methods In this study,three-dimensional finite element models of the pelvic bone and three-fin acetabular component were first established.The prosthesis model was characterized by three different conformational fins to facilitate and optimize the prosthetic design.The spongy and cortical bones were evaluated using a different modulus of elasticity in this established model.Results The maximum and minimum von Mises stresses on the fins of the acetabular component were 15.2 and 0.74,respectively.The maximum and minimum micromotion between the three-fin acetabular component and the acetabulum bone interface were 27 and 13 μm,respectively.A high primary stability and implied better clinical outcome were revealed.Conclusion Finite element analysis may be an optimal strategy for biomechanics-related research of prosthetic design for segmental acetabular bone defects.

  15. Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

    Kavanagh, E.C. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Read, P.; Carty, F.; Zoga, A.C. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Parvizi, J. [The Rothman Institute of Orthopedics, Philadelphia, PA (United States); Morrison, W.B., E-mail: [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)


    Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

  16. Displasia broncopulmonar Bronchopulmonary dysplasia

    Luciana F. Velloso Monte


    Full Text Available OBJETIVO: Apresentar uma ampla revisão da literatura sobre displasia broncopulmonar, abordando novas definições, fisiopatologia, prevenção, tratamento, prognóstico e evolução. FONTE DOS DADOS: Foram selecionados os artigos mais relevantes sobre o tema, desde a sua descrição inicial, em 1967, pesquisados na MEDLINE. SÍNTESE DOS DADOS: A displasia broncopulmonar é considerada uma das principais causas de doença pulmonar crônica em lactentes. Está associada a hospitalizações freqüentes e prolongadas, especialmente por doenças pulmonares, altos índices de mortalidade e alterações no desenvolvimento neuropsicomotor e no crescimento pôndero-estatural. A patogênese é complexa e influenciada principalmente por prematuridade, infecção, oxigênio suplementar e ventilação mecânica. A prevenção envolve o acompanhamento pré-natal adequado, a prevenção do parto prematuro, o uso pré-natal do corticosteróide, a terapia de reposição de surfactante e o uso de estratégias ventilatórias "protetoras". O tratamento do paciente com displasia broncopulmonar demanda uma equipe multidisciplinar. Quando indicada, a suplementação de oxigênio é de extrema importância. Apesar de maior risco de morbimortalidade nos primeiros anos de vida, a evolução em longo prazo é favorável na maioria das vezes. CONCLUSÕES: A displasia broncopulmonar vem sendo profundamente estudada na tentativa de identificação das suas causas e possibilidades de prevenção e de tratamento. Ainda existem controvérsias quanto a esses assuntos e também em relação ao prognóstico desses pacientes, especialmente quando se trata da evolução tardia da "nova" displasia broncopulmonar.OBJECTIVE: To present a wide-ranging review of the literature on bronchopulmonary dysplasia, covering new definitions, pathophysiology, prevention, treatment, prognosis and progression. SOURCES OF DATA: The most relevant articles published on the subject since it was first

  17. On cup anemometer rotor aerodynamics.

    Pindado, Santiago; Pérez, Javier; Avila-Sanchez, Sergio


    The influence of anemometer rotor shape parameters, such as the cups' front area or their center rotation radius on the anemometer's performance was analyzed. This analysis was based on calibrations performed on two different anemometers (one based on magnet system output signal, and the other one based on an opto-electronic system output signal), tested with 21 different rotors. The results were compared to the ones resulting from classical analytical models. The results clearly showed a linear dependency of both calibration constants, the slope and the offset, on the cups' center rotation radius, the influence of the front area of the cups also being observed. The analytical model of Kondo et al. was proved to be accurate if it is based on precise data related to the aerodynamic behavior of a rotor's cup.

  18. Aerodynamic characteristics of anemometer cups

    Brevoort, M J; Joyner, U T


    The static lift and drag forces on three hemispherical and two conical cups were measured over a range of angles of attack from 0 degrees to 180 degrees and a range of Reynolds Numbers from very small up to 400,000. The problems of supporting the cup for measurement and the effect of turbulence were also studied. The results were compared with those of other investigators.

  19. Análise epidemiológica das fraturas acetabulares Epidemiological analysis on acetabular fractures

    Maurício Silveira Maia


    Full Text Available O objetivo deste trabalho é realizar um estudo epidemiológico das fraturas acetabulares na cidade de Campinas e entorno, tendo em vista poucos trabalhos publicados a respeito deste assunto. Prontuários cedidos pelo Serviço de Arquivamento Médico (SAM do Hospital das Clínicas da Universidade Estadual de Campinas (Unicamp, dos anos de 2004 a 2008 com diagnósticos de fratura acetabular foram analisados por seis observadores que coletaram idade do paciente, sexo, lado acometido da fratura, mecanismo de lesão, material de síntese utilizado, complicações operatórias, fraturas associadas, tempo de internação pré e pós- operatória, tempo de internação total e número de sessões de fisioterapia pré e pós-cirurgia. Foi observado nesta demografia que o lado esquerdo foi o mais acometido; mecanismo de lesão que mais ocasiona esse tipo de fratura são os acidentes automobilísticos; das complicações cirúrgicas, as lesões do ciático tiveram maior ocorrência; o material de síntese mais utilizado são as placas de reconstrução.This aim of this work was to carry out an epidemiological study on acetabular fractures in the city of Campinas and surrounds, in view of the few published papers on this subject. Medical files with a diagnosis of acetabular fracture between the years 2004 and 2008 that were made available by the Medical Archiving Service of Hospital das Clínicas, State University of Campinas (UNICAMP were analyzed by six observers. Data on patients' ages, sex, side affected by the fracture, mechanism of injury, material used for synthesis, complications of the operation, associated fractures, length of hospitalization before and after the surgery, time of total internment and number of physiotherapy sessions before and after the surgery were gathered. It was observed in this population that the left side was more affected; the mechanism of injury that most often caused this type of fracture was automobile accidents

  20. Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature

    Uchida Kenzo


    Full Text Available Abstract Introduction Vascular complications related to cup-fixating screws penetrating the medial acetabular wall during total hip arthroplasty are not uncommon but rarely are associated with serious adverse events in the late post-operative period. Case presentation We present the case of a 77-year-old Japanese woman who developed progressive extensive bone resorption and large hematoma in the acetabulum 13 years after total hip arthroplasty. On admission to our hospital, she was on oral warfarin (1.5mg/day for atrial fibrillation. About 5 months after the initiation of anticoagulant therapy, she suffered a major fall followed by massive subcutaneous and pelvic girdle bleeding, predominantly on the medial side of the right thigh, but a fracture or damage of total hip arthroplasty was not evident on an emergency orthopedic evaluation. One year after the accident, a routine follow-up examination showed an asymptomatic osteolytic lesion in the acetabulum on the right pelvis, and 2 years later our patient noticed progressive pain in her right hip during walking. A large osteolytic lesion was noted in the right acetabulum on a plain radiograph. On high-resolution computed tomography and magnetic resonance imaging, a huge granulomatous lesion in the acetabulum was suggestive of chronic hematoma in intrapelvic and extrapelvic gluteal regions. A closer computed tomography examination showed that one of the screws used for fixation of the acetabular component in the total hip arthroplasty had penetrated the acetabular bone and had reached the pelvic cavity. Surgery was performed in a single session by means of two approaches: anterior midline transperitoneal address to resect the low-density mass lesion followed by posterolateral acetabular implant re-settlement. Conclusions Though rare, total hip arthroplasty-related late vascular complications could be serious and potentially affect the limb and quality of life.

  1. Spoon-to-Cup Fading as Treatment for Cup Drinking in a Child with Intestinal Failure

    Groff, Rebecca A.; Piazza, Cathleen C.; Zeleny, Jason R.; Dempsey, Jack R.


    We treated a child with intestinal failure who consumed solids on a spoon but not liquids from a cup. We used spoon-to-cup fading, which consisted of taping a spoon to a cup and then gradually moving the bowl of the spoon closer to the edge of the cup. Spoon-to-cup fading was effective for increasing consumption of liquids from a cup. (Contains 2…

  2. Acetabular fractures before and after the introduction of seatbelt legislation

    Al-Qahtani, Saeed; O’Connor, Gregory


    Objectives To compare the incidence and severity of acetabular fractures and associated injuries before and after seatbelt legislation. Design A retrospective study. Setting Two major trauma centres, which are teaching hospitals. Patients Three hundred and ninety-three patients who sustained acetabular fractures during the 5 years before and 5 years after seatbelt legislation was enacted. Of these, the fractures in 198 patients (50.4%) resulted from a motor vehicle accident. Main Outcome Measures The number and severity of acetabular fractures and associated injuries. Results There has been a significant reduction in the number of acetabular fractures (p = 0.005) since seatbelt use became mandatory, and the complexity of the fractures has decreased. There has also been a marked reduction in associated injuries, such as fractures of other bones, and head, chest and abdominal injuries (p < 0.001). Conclusion The seatbelt law has been a useful preventive measure, resulting in a reduction in the incidence of acetabular fractures and associated injuries. PMID:8697323

  3. A Novel Approach for Treatment of Acetabular Fractures

    Xue, Zichao; Qin, Hui; Ding, Haoliang; An, Zhiquan


    Background There is no single approach that provides adequate exposure for treatment of all types of acetabular fractures. We describe our experience with an easier, relatively less invasive pubic symphysis approach (PSA) for the treatment of acetabular fractures. Material/Methods Between March 2011 and March 2012, fifteen patients with acetabular fracture underwent surgery using the PSA technique. Fracture reduction and treatment outcomes were assessed by clinical and radiological examination. Operation time, intraoperative blood loss and postoperative complications were documented. Results Mean operative time was 222±78 minutes. Average blood loss was 993±361 mL. Anatomical reduction was achieved in all patients. Minimum follow-up period was 31 months. Postoperative hypoesthesia in the area of innervation of the lateral femoral cutaneous nerve was reported in one patient, with spontaneous recovery at one month after surgery. No complications were reported during the follow-up period. At the most recent follow up, clinical outcomes were graded as “excellent” in six patients, “good” in eight patients and “fair” in one patient based on the modified Merle d’Aubigné-Postel score. Conclusions PSA appears to be a timesaving and safe approach for treatment of acetabular fractures that affords good visual access and allows for excellent fracture reduction. Our preliminary results revealed a much lower incidence of complications than traditional approaches, suggesting PSA is an alternative for treatment of acetabular fractures. PMID:27734825

  4. Triple pelvic osteotomy in the treatment of hip dysplasia

    Vukašinović Zoran


    Full Text Available Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0° and Chiari osteotomy (31.4° (F=16.822; p<0.01. Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy and increase in joint

  5. Defining dysplasia in Barrett esophagus.

    Robert, Marie E


    Histologic grading of esophageal biopsies remains the cornerstone of management in patients with Barrett esophagus. This remains true despite ongoing research into the genetic abnormalities that occur in the setting of intestinal metaplasia, dysplasia, and adenocarcinoma of the esophagus. As of this writing, there are no objective tests that can replace the pathologist's eyes in predicting prognosis in this setting. However, pathologists and clinicians are well aware that the histologic interpretation of biopsies is an inherently subjective practice. The validity of this exercise depends entirely on the experience of the pathologist. Having said that, two interobserver studies on the grading of dysplasia in Barrett esophagus suggest that, if published criteria are adhered to, the histologic grading of dysplasia is a useful tool in patient management. In this review, the updated pathologic criteria for each category of dysplasia are presented, and the results of two large interobserver variability studies are reviewed.

  6. Ectodermal dysplasia with true anodontia

    Madhu Bala


    Full Text Available The hereditary condition known as ectodermal dysplasia is characterized by the absence or defect of two or more ectodermally derived structures. The most commonly observed forms of ectodermal dysplasia are the hidrotic and hypohidrotic types; discrimination is based on the absence or presence of sweat glands. A case of 8-year-old male child with hypohidrotic ectodermal dysplasia with complete anodontia of primary as well as secondary dentitions is presented. The child had a short stature, low intelligent quotient (I.Q.,, and was underweight. The patient experienced episodes of high fever, was intolerant to heat, and did not sweat. He exhibited smooth and dry skin, sparse light-colored eyebrows. Dental clinicians can be the first to diagnose ectodermal dysplasia due to the absence of teeth.

  7. Ellis-Van Creveld Dysplasia

    ... configuration along chromosome 4 (4p16), are responsible for EVC (3). Physical Characteristics Ellis-Van Creveld Dysplasia is ... 000 live births. More than 200 cases of EVC have now been reported (3). Face and Skull ...

  8. Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability.

    Sillesen, Nanna H; Greene, Meridith E; Nebergall, Audrey K; Nielsen, Poul T; Laursen, Mogens B; Troelsen, Anders; Malchau, Henrik


    Vitamin E diffusion into highly cross-linked polyethylene (E-XLPE) is a method for enhancing oxidative stability of acetabular liners. The purpose of this study was to evaluate in vivo penetration of E-XLPE using radiostereometric analysis (RSA). Eighty-four hips were recruited into a prospective 10-year RSA. This is the first evaluation of the multicenter cohort after 3-years. All patients received E-XLPE liners (E1, Biomet) and porous-titanium coated cups (Regenerex, Biomet). There was no difference (P=0.450) in median femoral head penetration into the E-XLPE liners at 3-years comparing cobalt-chrome heads (-0.028mm; inter-quartile range (IQR) - 0.065 to 0.047) with ceramic heads (-0.043mm, IQR - 0.143to0.042). The 3-year follow-up indicates minimal E-XLPE liner penetration regardless of head material and minimal early cup movement.

  9. Pediatric aspects of skeletal dysplasia.

    Ozono, Keiichi; Namba, Noriyuki; Kubota, Takuo; Kitaoka, Taichi; Miura, Kohji; Ohata, Yasuhisa; Fujiwara, Makoto; Miyoshi, Yoko; Michigami, Toshimi


    Skeletal dysplasia is a disorder of skeletal development characterized by abnormality in shape, length, a number and mineral density of the bone. Skeletal dysplasia is often associated with manifestation of other organs such as lung, brain and sensory systems. Skeletal dysplasias or dysostosis are classified with more than 400 different names. Enchondral bone formation is a coordinated event of chondrocyte proliferation, differentiation and exchange of terminally maturated chondrocyte with bone. Impaired enchondral bone formation will lead to skeletal dysplasia, especially associated with short long bones. Appropriate bone volume and mineral density are achieved by balance of bone formation and bone resorption and mineralization. The gene encoding fibroblast growth factor receptor 3 is responsible for achondroplasia, representative skeletal dysplasia with short stature. The treatment with growth hormone is approved for achondroplasia in Japan. Osteogenesis imperfecta is characterized by low bone mineral density and fragile bone. Data on the beneficial effect of bisphosphonate for osteogenesis imperfecta are accumulating. Osteopetrosis has high bone mineral density, but sometimes show bone fragility. In Japan as well as other countries, pediatrician treat larger numbers of patients with skeletal dysplasia with short stature and fragile bones compared to 20 years ago.

  10. Surgical Management of Acetabular Fractures: A Case Series

    Hassan Rahimi


    Full Text Available Introduction: For decades, acetabular fractures were treated conservatively. Judet et al. in 1960s established the operative treatment of these fractures by continuous improvement of pre-operative evaluation and classification of fractures. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcome.Case Series: We report 67 consecutive patients who underwent surgical treatment for acetabular fracture; 44 patients were available for follow-up. In 35 (79.5% cases, congruent reductions were achieved. The final mean Harris hip score was 81.8 (53-95. Functional outcomes according to Harris score were excellent and good in 31 patients (70.5%.Conclusions: The results of internal fixation of displaced acetabular fractures in our series were satisfactory.

  11. Development of site-specific locking plates for acetabular fractures.

    Xu, Meng; Zhang, Li-Hai; Zhang, Ying-Ze; He, Chun-Qing; Zhang, Li-Cheng; Wang, Yan; Tang, Pei-Fu


    Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.

  12. Acetabular anatomy and the relationship with pelvic vascular structures. Implications in hip surgery.

    Feugier, P; Fessy, M H; Béjui, J; Bouchet, A


    Most direct vascular trauma occurring during hip surgery results from injury to pelvic vascular structures which are not visible during the procedures of reaming, drilling holes or the fixation of screws. In this study, 5 pelves of fresh cadavers were injected with a radiopaque mixture and were visualised with a scanner according to 5 predetermined sections. Bone depth of the acetabulum was measured in each section. A calculation was made describing the minimal distance separating the inner cortex from the principal pelvic vessels. After an anatomic dissection of each pelvis, the relationship between the vessels and screws of the fixation cup, implanted identically on the quadranted acetabulum, was observed. The screws placed in the anterior and inferior quadrants and the center of the acetabulum endangered the external iliac v. and a. and the obturator pedicle. The depth of the periacetabular bone was greater in the superior and posterior quadrants. The inferior gluteal, pudendal and superior gluteal aa. were more than ten mm from the posterior wall. Conversely, the external iliac and obturator pedicles came in contact with the osseous surface on which they lay. A projection of the vessels on the acetabulum was made, and the reproducible character of the acetabular-quadrant system was verified. The superior quadrant offers all the characteristics of a vascular safe zone. A knowledge of these anatomic relationships explain vascular trauma in pelvic fractures and helps to prevent vascular injury in hip surgery.

  13. Can A Cup Anemometer `Underspeed'?

    Kristensen, L.

    An analysis of cup-anemometer dynamics has been carried out inorder to determine whether the mean-wind velocity can have anegative bias. This would be contrary to the general belief thatcup anemometers always overspeed. Compared to prior analyses, theeffect of a possible nonlinearity of the calibration function isincluded. The conclusion is that neither longitudinal nor lateralvelocity fluctuations can contribute significantly to a negativebias. However, if a cup anemometer has an angular response thatfalls below the ideal cosine response, there will, as demonstratedin the concluding discussion, be a negative contribution from thevertical velocity fluctuations to the total bias, and thiscontribution may even outbalance the positive contributions fromthe longitudinal velocity fluctuations. Concrete evidence of suchexotic cup anemometer behaviour has not been reported in theliterature.

  14. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J


    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  15. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

    Hideto Irifune


    Full Text Available Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

  16. Aerodynamic Investigation of a Cup Anemometer

    Hubbard, John D; Brescoll, George P


    This thesis presents the results of an investigation wherein the change of the normal force coefficient with Reynolds Number was obtained statically for a 15.5-centimeter hemisphere cup under the following conditions: (1) single cup with no interference; (2) single cup with three-cup interference; (3) four cups. The coefficients found in this research vary with Reynolds Number and are high as compared with those of Eiffel. The effect of interference upon a single cup is to increase the drag and normal force coefficients. The curve resulting from the summation of the coefficients for four cups agrees with the static torque curve of a Robinson type cup anemometer. All tests were carried on in the University of Detroit atmospheric wind tunnel during May 1933.

  17. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Logroscino Giandomenico


    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.


    R. M. Tikhilov


    Full Text Available Degenerative-dystrophic changes in hip after treatment of acetabular fracture, over the time, develops about in 60% of affected people. In such cases, total hip replacement is used. Existing classifications (for example AO or Letournel are good for fracture treatment, but not for arthritis following acetabular fracture. The group of patients, with post traumatic arthritis, is heterogeneous with severity of post traumatic anatomic changes. Basis for surgical approach, could be current classification for post traumatic changes – taking into account features of anatomic functional changes in hip and the bone defects of acetabulum. In this article is demonstrated X-ray and clinical basing for current classification.

  19. Cup tool use by squirrel monkeys.

    Buckmaster, Christine L; Hyde, Shellie A; Parker, Karen J; Lyons, David M


    Captive-born male and female squirrel monkeys spontaneously 'invented' a cup tool use technique to Contain (i.e., hold and control) food they reduced into fragments for consumption and to Contain water collected from a valve to drink. Food cup use was observed more frequently than water cup use. Observations indicate that 68% (n = 39/57) of monkeys in this population used a cup (a plastic slip cap) to Contain food, and a subset of these monkeys, 10% (n = 4/39), also used a cup to Contain water. Cup use was optional and did not replace, but supplemented, the hand/arm-to-mouth eating and direct valve drinking exhibited by all members of the population. Strategies monkeys used to bring food and cups together for food processing activity at preferred upper-level perching areas, in the arboreal-like environment in which they lived, provides evidence that monkeys may plan food processing activity with the cups. Specifically, prior to cup use monkeys obtained a cup first before food, or obtained food and a cup from the floor simultaneously, before transporting both items to upper-level perching areas. After food processing activity with cups monkeys rarely dropped the cups and more often placed the cups onto perching. Monkeys subsequently returned to use cups that they previously placed on perching after food processing activity. The latter behavior is consistent with the possibility that monkeys may keep cups at preferred perching sites for future food processing activity and merits experimental investigation. Reports of spontaneous tool use by squirrel monkeys are rare and this is the first report of population-level tool use. These findings offer insights into the cognitive abilities of squirrel monkeys and provide a new context for behavior studies with this genus and for comparative studies with other primates.

  20. 21 CFR 884.5400 - Menstrual cup.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Menstrual cup. 884.5400 Section 884.5400 Food and... OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices § 884.5400 Menstrual cup. (a) Identification. A menstrual cup is a receptacle placed in the vagina to collect...

  1. Coffee Cup Atomic Force Microscopy

    Ashkenaz, David E.; Hall, W. Paige; Haynes, Christy L.; Hicks, Erin M.; McFarland, Adam D.; Sherry, Leif J.; Stuart, Douglas A.; Wheeler, Korin E.; Yonzon, Chanda R.; Zhao, Jing; Godwin, Hilary A.; Van Duyne, Richard P.


    In this activity, students use a model created from a coffee cup or cardstock cutout to explore the working principle of an atomic force microscope (AFM). Students manipulate a model of an AFM, using it to examine various objects to retrieve topographic data and then graph and interpret results. The students observe that movement of the AFM…

  2. Genetics Home Reference: hypohidrotic ectodermal dysplasia

    ... Names for This Condition Anhidrotic Ectodermal Dysplasia Christ-Siemens-Touraine Syndrome CST syndrome HED Related Information How ... NORD) Resource list from the University of Kansas Medical Center GeneReviews (1 link) Hypohidrotic Ectodermal Dysplasia ClinicalTrials. ...

  3. Schimke immunoosseous dysplasia: Defining skeletal features

    K.B. Hunter (Kshamta); T. Lücke (Thomas); J. Spranger (Jürgen); S.F. Smithson (Sarah); H. Alpay (Harika); J.-L. André (Jean-Luc); Y. Asakura (Yumi); R. Bogdanovic (Radovan); D. Bonneau (Dominique); R. Cairns (Robyn); K. Cransberg (Karlien); S. Fründ (Stefan); H. Fryssira (Helen); D. Goodman (David); K. Helmke (Knut); B. Hinkelmann (Barbara); G. Lama (Guiliana); P. Lamfers (Petra); C. Loirat (Chantal); S. Majore (Silvia); C. Mayfield (Christy); B.F. Pontz (Betram); C. Rusu (Christina); J.M. Saraiva (Jorge); B. Schmidt (Beate); L. Schoemaker (Lawrence); S. Sigaudy (Sabine); N. Stajic (Natasa); D. Taha (Doris); C.F. Boerkoel (Cornelius)


    textabstractSchimke immunoosseous dysplasia (SIOD) is an autosomal recessive multisystem disorder characterized by prominent spondyloepiphyseal dysplasia, T cell deficiency, and focal segmental glomerulosclerosis. Biallelic mutations in swi/snf-related, matrix-associated, actin-dependent regulator o

  4. Central acetabular fracture dislocations: an unusual complication of seizures

    Lovelock, J.E.; Monaco, L.P.


    Central acetabular fracture-dislocations resulting from convulsions are rare. The literature is reviewed in this regard and we add two additional cases in which hyponatremia was the cause of seizure activity. In most cases this type of injury is seen in bone already weakened by underlying disease.

  5. Functional outcome of the surgical management of acute acetabular fractures

    Naseem Munshi; Asad Abbas; Mohamed Amirali Gulamhussein; Ghulam Mehboob; Rija Aitzaz Qureshi


    Objective:To assess the functional outcome of early surgical management of displaced acetabular fractures and the complications associated with the procedure. Methods: This is a case series study and data was collected using specialized performance. The study included 75 patients and the sampling technique was a non-probability purposive type. Patients presenting with close displaced acetabular fractures of more than 2 mm within 10 days of injury were included. However, elderly patients presenting after 10 days of injury, with evidence of local infection, severe osteoporotic bone and co-morbid such as chronic obstructive pulmonary disease were not included in the study. New acetabular scoring system was used for assessing outcome of patients. Results:A total of 75 patients were operated on. Union was achieved in anatomical position in 66 (88%) patients and in malposition in 9 (12%) patients. Excellent results were obtained in 18 (24%) patients, good results in 41 (54.6%), fair results in 12 (16%), and poor results in 4 (5.4%) patients. Postoperative complications included infection [5 (6.7%)], heterotropic ossification [3 (4%)], sciatic nerve injury [10 (13.3%)], avascular necrosis [3 (4%)] patients. Conclusions: Patients with displaced acetabular fractures should be referred to specialised centres. Early surgical intervention and experienced management is a prime factor in achieving good results.

  6. Chondroectodermal dysplasia: a rare syndrome.

    Dana Tahririan


    Full Text Available Chondroectodermal dysplasia (Ellis-Van Creveld syndrome is a rare autosomal recessive congenital abnormality. This syndrome is characterized by a spectrum of clinical findings, among which chondrodystrophy, polydactyly, ectodermal dysplasia, and congenital cardiac anomalies are the most common. It is imperative to not overlook the cardiac complications in patients with this syndrome during dental procedures. The case presented here, although quite rare, was detected under normal conditions and can be alarming for dental care providers. Clinical reports outline the classical and unusual oral and dental manifestations, which help health care providers diagnose chondroectodermal dysplasia, and refer patients with this syndrome to appropriate health care professionals to receive treatment to prevent further cardiac complications and bone deformities.

  7. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)


    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  8. Cementless acetabular fixation in patients 50 years and younger at 10 to 18 years of follow-up.

    Teusink, Matthew J; Callaghan, John J; Warth, Lucian C; Goetz, Devon D; Pedersen, Douglas R; Johnston, Richard C


    The purpose of the study was to evaluate the 10- to 18-year follow-up of cementless acetabular fixation in patients 50 years and younger. We retrospectively reviewed a consecutive group of 118 patients (144 hips) in whom primary total hip arthroplasty had been performed by 2 surgeons using a cementless acetabular component. Two (1.4%) cementless acetabular components were revised because of aseptic loosening. Twenty-four hips (16.7%) were revised for any mechanical failure of the acetabular component mostly related to acetabular liner wear and osteolysis. The average linear wear rate was 0.19 mm per year, which was higher than our previous reports with cemented acetabular fixation. The fiber mesh ingrowth surface of the cementless acetabular component in this study was superior to cemented acetabular components in terms of fixation. However, the high rates of wear and osteolysis have led to poor overall acetabular component construct survivorship.

  9. The nature of fibrous dysplasia

    Lemmer Johan


    Full Text Available Abstract Fibrous dysplasia has been regarded as a developmental skeletal disorder characterized by replacement of normal bone with benign cellular fibrous connective tissue. It has now become evident that fibrous dysplasia is a genetic disease caused by somatic activating mutation of the Gsα subunit of G protein-coupled receptor resulting in upregulation of cAMP. This leads to defects in differentiation of osteoblasts with subsequent production of abnormal bone in an abundant fibrous stroma. In addition there is an increased production of IL-6 by mutated stromal fibrous dysplastic cells that induce osteoclastic bone resorption.

  10. Anomalies of the natural correction of dysplasia of the hip and treatment proposals.

    Terver, S; Hery, J Y; Faher, M; Picquel, X; Castillo, O


    The spontaneous correction of hip dysplasia occurs at every level of growth of the lower limb and it may be inadequate at any of these levels. Every abnormality of correction may induce different troubles at any level of the lower limb. A complete clinical evaluation, X-ray with different special views and CT examination is mandatory. Every deformation in any of the three spatial planes must be detected for a good understanding of the defect. The authors describe the X-ray techniques necessary for a complete evaluation of the patient and propose a CT protocol to precisely calculate the different angles of torsion of the lower limb. The possibilities of surgical treatment at different levels of the lower limb (acetabular, femoral, tibial and ankle or foot level) in DDH are pointed out to address directly the proper procedure at the correct level of the pathology.

  11. Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

    Narasimhan Ramani


    Materials and Methods: 35 children with unilateral DDH were operated between 2002 and 2007 at our institute. Open reduction was performed in all using the standard anterior approach and peroperative test for hip stability was done. Nine children got an additional pelvic procedure in the form of Dega acetabuloplasty. All were followed up for a minimal period of 2 years (range 2-7 years. Results: No hip got redislocated. At the end of 18 months, there were seven cases of RAD with acetabular index (AI of 35° and above. These were all from the group where open reduction alone was done. Conclusion: We feel that a preoperative AI of >40° and a per-operative safe-zone <20° increases the need for supplementary pelvic osteotomy in age group of 18 to 24 months because in such cases, the remodeling capacity of the acetabulum is unable to overcome the dysplasia and to form a relatively normal acetabulum.

  12. Prognostic radiographic factors in developmental dysplasia of the hip following Salter osteotomy.

    Chang, Chia-Hsieh; Yang, Wen-E; Kao, Hsuan-Kai; Lee, Wei-Chun; Shih, Chun-Hsiung; Kuo, Ken N


    Radiographic parameters for evaluating hip development are altered by Salter osteotomy, and their prognostic value require further validation. A total of 63 patients who underwent open reduction and Salter osteotomy for unilateral hip dysplasia were evaluated with Severin classification 10.8 years later. The initial first-year postoperative acetabular index, c/b ratio, head-teardrop distance, and head coverage were compared with the final outcome of Severin classification. Greater c/b ratio was significantly associated with later Severin class III hip. Using receiver operating characteristics curve, a c/b ratio greater than 0.72 at 6 months and 1 year postoperatively can predict the possibility of a class III hip in 30 and 60% of patients, respectively.


    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra


    Objective: To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Methods: Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. Results: The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. Conclusion: The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk. PMID:27027068

  14. Experimental Investigation of the Robinson-Type Cup Anemometer

    Brevoort, M J; Joyner, U T


    This report presents the results of wind tunnel tests on a Robinson-type anemometer. The investigation covered force measurements on individual cups, as well as static and dynamic torque measurements and calibrations on complete cup wheels. In the tests on individual cups 5 cup forms were used and in the measurements on complete cup wheels 4 cup wheels with 3 arm lengths for each cup wheel were tested. All the results are presented in graphical form.

  15. Fourier analysis of the aerodynamic behavior of cup anemometers

    Pindado Carrion, Santiago; Pérez Sarasola, Imanol; Aguado Roca, Maite


    The calibration results (the transfer function) of an anemometer equipped with several cup rotors were analyzed and correlated with the aerodynamic forces measured on the isolated cups in a wind tunnel. The correlation was based on a Fourier analysis of the normal-to-the-cup aerodynamic force. Three different cup shapes were studied: typical conical cups, elliptical cups and porous cups (conical-truncated shape). Results indicated a good correlation between the anemometer factor, K, and the r...

  16. On Cup Anemometer Rotor Aerodynamics

    Santiago Pindado


    Full Text Available The influence of anemometer rotor shape parameters, such as the cups’ front area or their center rotation radius on the anemometer’s performance was analyzed. This analysis was based on calibrations performed on two different anemometers (one based on magnet system output signal, and the other one based on an opto-electronic system output signal, tested with 21 different rotors. The results were compared to the ones resulting from classical analytical models. The results clearly showed a linear dependency of both calibration constants, the slope and the offset, on the cups’ center rotation radius, the influence of the front area of the cups also being observed. The analytical model of Kondo et al. was proved to be accurate if it is based on precise data related to the aerodynamic behavior of a rotor’s cup.

  17. Oral epithelial dysplasia classification systems

    Warnakulasuriya, S; Reibel, J; Bouquot, J


    ) and was of the view that reducing the number of choices from 3 to 2 may increase the likelihood of agreement between pathologists. The utility of this need to be tested in future studies. The variables that are likely to affect oral epithelial dysplasia scoring were discussed and are outlined here; these need...

  18. Genetics Home Reference: otospondylomegaepiphyseal dysplasia

    ... 1):33-5. Citation on PubMed Melkoniemi M, Brunner HG, Manouvrier S, Hennekam R, Superti-Furga A, Kääriäinen ... de Waal Malefijt MC, van den Hoogen FH, Brunner HG. Oto- spondylo-megaepiphyseal dysplasia (OSMED): clinical description ...

  19. Aumento acetabular pela técnica de Stahelli modificada Acetabular increase with modified Stahelli technique

    Sílvio Pereira Coelho


    Full Text Available Os autores apresentam neste trabalho um estudo retrospectivo realizado em 18 pacientes submetidos a tratamento cirúrgico de insuficiência acetabular pela osteotomia da pelve seguindo a técnica descrita por Lynn T. Staheli. Enfatizam a modificação da técnica deste autor, com a introdução do enxerto ósseo, retirado da tábua externa do ilíaco, numa fenda aprofundada até cerca da cortical interna do ilíaco. Os pacientes foram acompanhados através de consultas ambulatoriais previamente a cirurgia e pós-operatoriamente com seguimento que variou de 2 meses a 4 anos no serviço de ortopedia infantil do Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. O objetivo do trabalho foi avaliar o quadril acometido pré e pós-operatoriamente, demonstrando a evolução e vantagens da variação da técnica de Staheli desenvolvida neste serviço. Observou-se que a cirurgia, se realizada sob técnica adequada e em mãos experientes, torna-se uma fonte válida de tratamento para aquelas patologias que levam a uma insuficiente cobertura da cabeça femoral.The authors present in this paper a retrospective study of eighteen patients treated surgically for insufficiency of the acetabular coverage with the shelf procedure according to Lynn T. Staheli. This study was done at the Service of Pediatric Orthopedics of Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. They call attention to the modification of the surgical technique in that the bone graft taken from outer cortex of the iliac bone, is deepened in the slot in the superior rim of the acetabulum. The follow-up ranged from two months to four years. The aim of this paper was to evaluate the affected hip pre and postoperatively showing the results and the advantages of the modified shelf technique. They observed that if the surgery is performed according to the correct technique and by an experienced surgeon, it is a very good alternative to the treatment of those

  20. Factitious panniculitis induced by cupping therapy.

    Moon, Suk-Ho; Han, Hyun-Ho; Rhie, Jong-Won


    Cupping therapy is an alternative medical procedure that has been widely performed in Asian countries to relieve pain. It is known that there is no complication to this therapy, so many non-health care professionals have performed this procedure. However, there have been few reports on complications, such as iron deficiency anemia, hemorrhagic bullae, kelloids, vasovagal syncope, and foreign body reactions. Masses associated with panniculitis induced by cupping are extremely rare, and they require a unique approach.A 56-year-old woman presented with a 10-month history of multiple masses in the posterior neck and right shoulder areas. The patient repeatedly attempted cupping therapy by herself, and multiple palpable masses developed in the posterior neck and right shoulder area where cupping therapy had been performed. The masses were enlarged by repeated cupping, and they decreased in size when cupping was stopped. Among all lesions, the 2 masses with tenderness were surgically excised. The remaining masses resolved after cupping therapy was ceased. When a patient with subcutaneous mass has a history of cupping or trace of cupping marks, panniculitis induced by cupping should be suspected. The lesion seems to spontaneously resolve unless they are repeatedly stimulated. However, surgical resection is considered in patients with infections or severe tenderness as a complication.

  1. Validation of a new radiographic measurement of acetabular version: the transverse axis distance (TAD)

    Nitschke, Ashley [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology, Aurora, CO (United States); Lambert, Jeffery R. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); Glueck, Deborah H. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); University of Colorado School of Medicine, University of Colorado Denver, Department of Radiology, Aurora, CO (United States); Jesse, Mary Kristen; Strickland, Colin [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Mei-Dan, Omer [University of Colorado School of Medicine, University of Colorado Denver, Division of Sports Medicine and Hip Preservation, Department of Orthopaedics, Aurora, CO (United States); Petersen, Brian [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Inland Imaging, Division of Musculoskeletal Radiology, Spokane, WA (United States)


    This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD. A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD. CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82. TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain. (orig.)

  2. 全髋关节置换术中髋臼假体定位的研究进展%Progress of research on the orientation of the acetabular component in total hip arthroplasty

    胡海贝; 周建生


    目前全髋关节置换术已成为治疗终末期髋关节疾病的有效手段,由于髋臼侧结构的特殊性,髋臼杯位置的定位方法尚有争议。髋臼假体定位方法主要有根据术前、术中影像学资料定位,根据髋臼局部解剖特征和(或)结合机械设备定位等,本文就髋臼假体位置定位的研究进展作一综述。%At present,total hip arthroplasty has become an effective method for the treatment of end-stage hip disease.Because of the special structure of the acetabulum,the methods for determining the position of the ace-tabular cup are disputed.The orientation methods of the acetabular components are mainly determined by the preop-erative and intraoperative imaging data,local anatomical characteristics of the acetabulum in combination with the mechanical equipment.This paper reviews the progress in research on orientating acetabular prosthesis position.

  3. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    Kuhlman, J.E.; Fishman, E.K.; Ney, D.R.; Brooker, A.F. Jr.; Magid, D.


    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion.

  4. Cupping for hypertension: a systematic review.

    Lee, Myeong Soo; Choi, Tae-Young; Shin, Byung-Cheul; Kim, Jong-In; Nam, Sang-Soo


    The objective of this review is to assess the clinical evidence for or against cupping as a treatment for hypertension. We searched the literature using 15 databases from their inception to 30 June 2009, without language restrictions. We included all clinical trials (CTs) of cupping to treat hypertension in human patients. Risk of bias was assessed using the Cochrane criteria. Two CTs met all inclusion criteria. One RCT (randomized CT) assessed the effectiveness of dry cupping on changes in cerebral vascular function compared with drug therapy. Their results suggested significant effect in favor of cupping on vascular compliance and degree of vascular filling. One uncontrolled observational study (UOS) tested wet cupping for acute hypertension and found that a one-time treatment reduced blood pressure. In conclusion, the evidence is not significantly convincing to suggest cupping is effective for treating hypertension. Further research is required to investigate whether it generates any specific effects for that condition.

  5. Multiplanar and 3D CT of acetabular fractures

    Haveri, M.; Suramo, I.; Laehde, S. [Oulu Univ., Dept. of Diagnostic Radiology (Finland); Junila, J. [Oulu Univ., Dept. of Orthopaedic Surgery (Finland)


    Purpose: To establish a standard protocol for the multiplanar (MPR) and 3D shaded surface display (SSD) reconstruction of CT data on acetabular fractures, and to assess the usefulness of these reformats. Material and Methods: Acetabular fractures in 15 patients were imaged by means of plain radiographs, transaxial CT, MPR reformats, and SSD reformats. Results: The classification of the acetabular fracture was revised in 7/15 cases when the transaxial CT images were read after the plain radiographs. Although the MPR and SSD reformats did not alter the classification, they did add to the degree of confidence in the diagnosis in 9/15 cases. In 2 patients, the MPR and SSD reformats indicated operative instead of conservative treatment. In the MPR reformats, the following views were considered essential in all cases: (a) along the anterior column; (b) along the posterior column; and (c) along both columns and the inferior ramus. In the SSD reformats, the following views were considered essential in all cases: (d) the latero-caudal en face view into the acetabulum; and 180 opposite to this, (e) the medio-cranial view (facing the quadrilateral plate). In 10/15 cases, these views were all that was needed for classification. It was, however, essential to remove the femur from the images before reconstructing the SSD views. Conclusion: Complex acetabular fractures with displacement should be evaluated by means of transaxial CT and additional MPR and SSD reformats. The use of appropriate standard MPR and SSD views shortens the time required to produce the reformats and thereby maximizes the benefit gained. (orig.).

  6. Lamp with a truncated reflector cup

    Li, Ming; Allen, Steven C.; Bazydola, Sarah; Ghiu, Camil-Daniel


    A lamp assembly, and method for making same. The lamp assembly includes first and second truncated reflector cups. The lamp assembly also includes at least one base plate disposed between the first and second truncated reflector cups, and a light engine disposed on a top surface of the at least one base plate. The light engine is configured to emit light to be reflected by one of the first and second truncated reflector cups.

  7. Pelvic muscle and acetabular contact forces during gait.

    Pedersen, D R; Brand, R A; Davy, D T


    Locations, magnitudes, and directions of pelvic muscle and acetabular contact forces are important to model the effects of abnormal conditions (e.g., deformity, surgery) of the hip accurately. Such data have not been reported previously. We computed the three-dimensional locations of all pelvic muscle and acetabular contact forces during level gait. The approach first required computation of the intersegmental joint resultant forces and moments using limb displacement history, foot-floor forces, and estimated limb inertial properties from one subject. The intersegmental resultant moments were then distributed to the muscles using a 47-element muscle model and a non-linear optimization scheme. Muscle forces were vectorally subtracted from the intersegmental resultants to compute the acetabular contact forces. While the peak joint force magnitudes are similar to those reported previously for the femur, the directions of pelvic contact forces and muscle forces varied considerably over the gait cycle. These variations in contact force directions and three-dimensional forces could be as important as the contact force magnitudes in performing experimental or theoretical studies of loads and stresses in the periacetabular region.

  8. The Use of Iliac Stem Prosthesis for Acetabular Defects following Resections for Periacetabular Tumors

    Massimiliano De Paolis


    Full Text Available Introduction. The management of pelvic tumors is a challenge for orthopaedic oncologists due to the complex anatomy of the pelvis and the need to have extensive exposure. Various reconstructive techniques have been proposed with poor functional results and a high percentage of complications. Our purpose is to determine the functional results and the rate of complications of iliac stem prosthesis for acetabular defects following resections for periacetabular tumors. Materials and Methods. Between 1999 and 2012, 45 patients underwent pelvic resections for periacetabular bone tumors followed by reconstruction with stem cup prosthesis. The most common diagnosis was CS (chondrosarcoma, 29 cases, followed by OS (osteosarcoma, 9 cases and metastasis (3 cases. In 33 cases, this implant was associated with massive bone allografts. Minimum follow-up required to evaluate functional outcome was 2 years. We classified pelvic resections according to Enneking and Dunham’s classification and we used MSTS (musculoskeletal tumor system score to evaluate functional outcomes. Results and Discussion. Sixteen patients died of their disease, three were lost to follow-up, four are alive with disease, and twenty-two are alive with no evidence of disease. Fifteen patients had local recurrence. Sixteen patients had bone or lung metastasis. We have had 6 infections, 2 aseptic loosening, and 2 cases of hip dislocation. Iliac sovracetabular osteotomy was fused in all cases at 10 months from surgery. Functional results were good or excellent in 25 of 31 patients with long-term follow-up (77%, with a percentage similar to that reported in the literature. Conclusion. The use of iliac stem prosthesis is a simple reconstructive technique that reduces operative times and risk of infection. It allows having good results and low rate of complications, but it should be performed in selected cases and centres of reference.

  9. Cleidocranial dysplasia: a case report

    Han, Jin Won [Kangnung National University College of Medicine, Kangnung (Korea, Republic of)


    Cleidocranial dysplasia is a rare, autosomal dominant congenital disorder. A 12-year-old female visited with chief complaint of unerupted permanent teeth. Also her father showed severe class III malocclusion. The extraoral radiography and computed tomography showed delayed closure of the cranial sutures and underdevelopment of maxilla, maxillary sinuses, and frontal sinus. Both clavicles were underdeveloped and thoracic rib cage was bell-shaped. Both zygomatic process appeared as hypoplastic feature. There were many unerupted permanent and supernumerary teeth in the maxilla and mandible. We examined location and number of the unerupted teeth using 3D CT. Finally we could conclude this case was cleidocranial dysplasia based on the clinico-radiologic findings.

  10. Skeletal dysplasias: A radiographic approach and review of common non-lethal skeletal dysplasias

    Ananya; Panda; Shivanand; Gamanagatti; Manisha; Jana; Arun; Kumar; Gupta


    Skeletal dysplasias are not uncommon entities and a radiologist is likely to encounter a suspected case of dysplasia in his practice. The correct and early diagnosis of dysplasia is important for management of complications and for future genetic counselling. While there is an exhaustive classification system on dysplasias, it is important to be familiar with the radiological features of common dysplasias. In this article, we enumerate a radiographic approach to skeletal dysplasias, describe the essential as well as differentiating features of common non-lethal skeletal dysplasias and conclude by presenting working algorithms to either definitively diagnose a particular dysplasia or suggest the most likely differential diagnoses to the referring clinician and thus direct further workup of the patient.

  11. Field calibration of cup anemometers

    Kristensen, L.; Jensen, G.; Hansen, A.


    An outdoor calibration facility for cup anemometers, where the signals from 10 anemometers of which at least one is a reference can be can be recorded simultaneously, has been established. The results are discussed with special emphasis on the statisticalsignificance of the calibration expressions....... It is concluded that the method has the advantage that many anemometers can be calibrated accurately with a minimum of work and cost. The obvious disadvantage is that the calibration of a set of anemometersmay take more than one month in order to have wind speeds covering a sufficiently large magnitude range...

  12. Skeletal dysplasia in ancient Egypt.

    Kozma, Chahira


    The ancient Egyptian civilization lasted for over 3000 years and ended in 30 BCE. Many aspects of ancient Egyptian culture, including the existence of skeletal dysplasias, and in particular achondroplasia, are well known through the monuments and records that survived until modern times. The hot and dry climate in Egypt allowed for the preservation of bodies and skeletal anomalies. The oldest dwarf skeleton, the Badarian skeleton (4500 BCE), possibly represents an epiphyseal disorder. Among the remains of dwarfs with achondroplasia from ancient Egypt (2686-2190 BCE), exists a skeleton of a pregnant female, believed to have died during delivery with a baby's remains in situ. British museums have partial skeletons of dwarfs with achondroplasia, humeri probably affected with mucopolysaccharidoses, and a skeleton of a child with osteogenesis imperfecta. Skeletal dysplasia is also found among royal remains. The mummy of the pharaoh Siptah (1342-1197 BCE) shows a deformity of the left leg and foot. A mummified fetus, believed to be the daughter of king Tutankhamun, has scoliosis, spina bifida, and Sprengel deformity. In 2006 I reviewed the previously existing knowledge of dwarfism in ancient Egypt. The purpose of this second historical review is to add to that knowledge with an expanded contribution. The artistic documentation of people with skeletal dysplasia from ancient Egypt is plentiful including hundreds of amulets, statues, and drawing on tomb and temple walls. Examination of artistic reliefs provides a glance of the role of people with skeletal dysplasia and the societal attitudes toward them. Both artistic evidence and moral teachings in ancient Egypt reveal wide integration of individuals with disabilities into the society.

  13. Spondyloepiphyseal Dysplasia Tarda in Twins

    Ferhat Çekmez


    Full Text Available Introduction: Spondyloepiphyseal dysplasia (SED is a genetically heterogeneous disorder often associated with the early onset of osteoarthrosis. The X-linked recessive form (SEDL affects boys and is characterized by reduced height, arm span exceeding total height, and barrel chest deformity. The radiographic phenotype comprises a hump-shaped deformity of vertebral bodies and mild epiphyseal dysplasia of the femoral head associated with early signs of hip arthrosis.The disorder is caused by mutations in the SEDL (or sedlin gene on Xp22.12-p22.31. SED should be kept in mind as a differential diagnosis in men with early “primary” bilateral osteoarthrosis.Case Report: Here, 11 years old twins diagnosed as SED due to walking disability, limitation of joint motion, pain at the hips and disability in standing for a long time were presented. Discussion: This rare skelatal dysplasia must be kept in mind in patients with painful spine and hip joints, and walking disability. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2011; 9: 97-9

  14. Ipsilateral Hip Dysplasia in Patients with Sacral Hemiagenesis: A Report of Two Cases

    Tadatsugu Morimoto


    Full Text Available Sacral agenesis (SA is a rare condition consisting of the imperfect development of any part of the sacrum. This paper describes two cases of the rare cooccurrence of ipsilateral SA and developmental dysplasia of the hip (DDH and analyzes possible contributory factors for SA and DDH. Each of a 16-year-old female and 13-year-old female visited our hospital for left hip pain and limping. The findings of physical examinations showed a lower limb length discrepancy (left side in both cases, as well as left hip pain without limitations of the range of motion or neurological deficits. Initial radiographs demonstrated left subluxation of the left hip with associated acetabular dysplasia and partial left sacral agenesis. MRI revealed a tethering cord with a fatty filum terminale, and periacetabular osteotomy combined with allogeneic bone grafting was performed. After the surgery, the patients experienced no further pain, with no leg length discrepancy and were able to walk without a limp, being neurologically normal with a normal left hip range of motion. The cooccurrence of SA and DDH suggests a plausible hypothesis to explain the embryogenic relationship between malformation of the sacrum and hip.

  15. Optic Nerve Decompression for Orbitofrontal Fibrous Dysplasia

    Abe, Takumi; Sato, Kaneshige; Otsuka, Takaharu; Kawamura, Noriyoshi; Shimazu, Motohiko; Izumiyama, Hitoshi; Matsumoto, Kiyoshi


    Orbitofrontal fibrous dysplasia often involves the bony orbit and the optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual distrubances, optic nerve decompression in patients without clinical signs of optic neuropathy is still controversial. We describe two patients with orbitofrontal fibrous dysplasia without signs of visual disturbance and one patient with McCune-Albright syndrome and progressive visual impairment. Optic nerve decompre...

  16. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.


    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  17. Soccer jersey sponsors and the world cup

    Groot, L.F.M.; Ferwerda, J.


    The market for soccer jerseys is a multibillion market dominated by Adidas, Nike and Puma. This paper investigates whether jersey sponsorship has a non-arbitrary effect on the outcomes of World Cup knockout matches. The results show that in the knockout stages of the last four World Cup tournaments,

  18. Presentation of hypohidrotic ectodermal dysplasia in two siblings

    Uday Ginjupally


    Full Text Available Ectodermal dysplasias are a large hereditary group of disorders which are usually manifested as X-linked recessive disorders and have a full expression in males, whereas females show little to no signs of the disorder. The two most common types of ectodermal dysplasias are hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome and hidrotic ectodermal dysplasia (Clouston syndrome. Hypohidrotic ectodermal dysplasia is characterized by hypodontia, hypotrichosis, and hypohidrosis. Here, we present two female sibling cases of hypohidrotic ectodermal dysplasia.

  19. Fourier analysis of the aerodynamic behavior of cup anemometers

    Pindado, Santiago; Pérez, Imanol; Aguado, Maite


    The calibration results (the transfer function) of an anemometer equipped with several cup rotors were analyzed and correlated with the aerodynamic forces measured on the isolated cups in a wind tunnel. The correlation was based on a Fourier analysis of the normal-to-the-cup aerodynamic force. Three different cup shapes were studied: typical conical cups, elliptical cups and porous cups (conical-truncated shape). Results indicated a good correlation between the anemometer factor, K, and the ratio between the first two coefficients in the Fourier series decomposition of the normal-to-the-cup aerodynamic force.

  20. Sacroiliac joint dysfunction as a reason for the development of acetabular retroversion: a new theory.

    Cibulka, Michael T


    Acetabular retroversion has been recently implicated as an important factor in the development of femoral acetabular impingement and hip osteoarthritis. The proper function of the hip joint requires that the anatomic features of the acetabulum and femoral head complement one another. In acetabular retroversion, the alignment of the acetabulum is altered where it opens in a posterolaterally instead of anterior direction. Changes in acetabular orientation can occur with alterations in pelvic tilt (anterior/posterior), and pelvic rotation (left/right). An overlooked problem that alters pelvic tilt and rotation, often seen by physical therapists, is sacroiliac joint dysfunction. A unique feature that develops in patients with sacroiliac joint dysfunction (SIJD) is asymmetry between the left and right innominate bones that can alter pelvic tilt and rotation. This article puts forth a theory suggesting that acetabular retroversion may be produced by sacroiliac joint dysfunction.

  1. Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

    Iori Takigami


    Full Text Available Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA, typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

  2. One stage total hip arthroplasty for acetabular fractures%Ⅰ期全髋关节置换治疗髋臼骨折

    王子明; 孙红振; 王爱民; 杜全印; 吴思宇; 赵玉峰; 唐颖


    目的 探讨髋臼骨折后Ⅰ期全髋关节置换(total hip arthroplasty,THA)的手术适应证和手术方法,观察其临床疗效.方法 对11例髋臼骨折患者行Ⅰ期THA.其中前柱骨折3例,后壁骨折1例,后柱骨折2例,后柱合并后壁骨折2例,横形骨折1例,横形合并后壁骨折1例,两柱骨折1例.伤后8~37 d(平均24 d)接受THA.对新鲜髋臼骨折患者,先用重建钢板或螺钉固定骨折以恢复髋臼肇的形态,将切下的股骨头制成颗粒状或块状植于髋臼内后安置臼杯.陈旧性髋臼骨折有节段性髋臼骨缺损者,将切下的股骨头制成大块状进行髋臼内结构性植骨后再安置臼杯.结果 术后3个月完全负重,无人工关节脱位.随访时间6~45个月,平均28个月.Harris评分平均78分.髋关节屈伸平均活动度为95°.X线片示1例出现髋臼松动及骨溶解征象.结论 髋臼骨折移位明显,关节软骨面损伤严重,错过了手术复位时机,可以Ⅰ期行THA.如能创造稳定的髋臼杯结构,近期临床效果满意.%Objective To explore operative indications,methods and effect of one stage total hip arthroplasty(THA)in treatment of acetabular fractures.Methods One stage total hip arthroplasty (THA)was carried out in 11 patients with acetabular fractures including 10 males and one female(at mean age of 42.4 years)8-37 days(mean24 days)after injury.There were anterior column fractures in three patients,posterior wall fracture in one,posterior column fracture in two,posterior column fracture combined with posterior wall fracture in two,transverse fracture in one,transverse fracture combined with posterior wall fracture in one and two-column fracture in one.Fresh acetabular fractures were first fixed with reconstruction plate or screws to restore shape of acestbular wall;then,granule or bulk of resected femoral head were implanted into acetabulum posterior to placement of acetabular cup prosthesis.While for old acetabular fractures,the resected

  3. Vacuum extraction: a randomized controlled comparison of the New Generation cup with the original Bird cup.

    Carmody, F; Grant, A; Somchiwong, M


    A new design of vacuum extractor cup--'the New Generation cup'--has recently been introduced into clinical practice. Its major modification is a traction cord which passes around the rim of the cup for 180 degrees and is free to slide within the rim. Claims that this design 'enables the operator to pull obliquely without causing the cup to tilt' and thereby 'reduces failure rates, reduces the incidence of scalp trauma and increases operator confidence' have been evaluated in a randomized controlled trial. 123 women with singleton pregnancies of 37 completed weeks or more, with a cephalic presentation and for whom a decision to deliver by vacuum extraction had been taken, were randomly allocated to the 'New Generation' cup or BIRD's original vacuum extractor cup; 50 mm anterior and posterior cups were used in both groups as appropriate. The two groups were comparable at entry and delivered by obstetricians of similar status. The two types of cup were similar in respect of number of failures to deliver with the vacuum extractor, correct positioning of the cup, number of pulls required for delivery and time taken to expedite delivery. Cup detachments occurred in nine cases allocated to the 'New Generation' cup compared with four allocated to the original BIRD cup. The babies in the two groups were in similar condition at birth and sustained similar amounts of scalp trauma. Neonatal jaundice, both clinical and biochemical, was more common in babies delivered with the 'New Generation cup' and this was reflected in greater use of phototherapy in this group. Operators were equally divided in their preference of cup.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Clinical and radiographic medium‐term evaluation on patients with developmental dysplasia of the hip, who were submitted to open reduction, capsuloplasty and Salter osteotomy☆☆☆

    da Rocha, Válney Luiz; Marques, Guilherme Lima; da Silva, Leonardo Jorge; di Macedo Bernardes, Tiago Augusto; de Moraes, Frederico Barra


    Objective to evaluate the clinical and radiographic medium‐term results from surgical treatment of developmental dysplasia through open reduction, Salter et al.’s osteotomy and capsuloplasty. Methods 13 patients were evaluated, 13 hips treated surgically by the proposed technique between 2004 and 2011. A clinical and radiographic evaluation was conducted by Dutoit et al. and Severin et al. criteria, respectively. Results the acetabular preoperative index for the 13 surgically treated hips ranged from 27° to 50° (average of 36), and after surgical correction to 18.5° (10–28°), so that the evaluations of preoperative and postoperative acetabular indexes showed up significant statistic reduction (p  0.05). As complications occurred, it was found that three subluxations and a subluxation associated with avascular necrosis of the femoral head. Conclusion open reduction, Salter et al.’s osteotomy and capsuloplasty are seen to be a viable option for the treatment of developmental dysplasia of the hip, according to clinical and radiological medium‐term evaluations. PMID:26229772

  5. Higher wear-rate of third-generation metal-backed Reflection cups with eto-sterilised UHMWPE at a mean 13 years follow-up.

    Hengst, David M; Thomsen, Per B; Homilius, Morten; Hansen, Torben B; Stilling, Maiken


    Polyethylene (PE) wear and osteolysis is a recognised problem with non-cross linked PE liners and first generation modular cup designs. Wear particles induce osteolysis leading to aseptic loosening. We retrospectively compared the linear PE wear and implant survival and revision rates of the Reflection Cup and the Duraloc 300. After a mean clinical follow-up of 13 years (range 11-15 years), the 2D linear PE wear-rate of the Reflection liner (n = 68) was 0.23 mm/year, with a mean total wear of 3.14 mm (1.04-7.36), SD 1.45. The wear-rate of the Duraloc 300 cups (n = 32) was 0.14 mm/year, with a mean total wear of 1.84 mm (0.55-4.63), SD 1.07. The difference in PE wear-rate as well as mean total wear was highly significant (p = 0.0001). There was a positive correlation between wear-rate and both Oxford Hip Score and Harris Hip Score (p = 0.02). Large acetabular cup size (>54 mm), HA coating on the stem and age <50 years did not influence PE wear. The higher wear-rate in the Reflection liners could be related to the EtO sterilisation. Intermediate and long-term follow-up is advisable.

  6. Radiographic measurements of hip dysplasia at skeletal maturity - new reference intervals based on 2,038 19-year-old Norwegians

    Laborie, Lene Bjerke; Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Engesaeter, Ingvild Oevsteboe [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Lehmann, Trude Gundersen; Engesaeter, Lars Birger [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Sera, Francesco; Dezateux, Carol [UCL Institute of Child Health, MRC Centre of Epidemiology for Child Health, London (United Kingdom)


    Normative references for radiographic measurements commonly used in the diagnosis of developmental dysplasia of the hip at skeletal maturity are incomplete. The present study therefore aimed to establish new gender-specific standards for measurements reflecting the acetabular morphology, namely Sharp's angle, the acetabular roof angle of Toennis (AA) and the acetabular depth-width ratio (ADR), and measurements reflecting the position of the femoral head related to the acetabulum, namely the center-edge (CE) angle of Wiberg, the refined CE angle of Ogata, and the femoral head extrusion index (FHEI). The joint space width (JSW) is also reported. The population-based 1989 Bergen Birth Cohort (n = 3,935) was invited at age 19 years to a follow-up during 2007-09, of which 2,038 (52 %) attended. A standardized antero-posterior radiograph was assessed. The normative references are presented as mean {+-} standard deviation (SD) and 2.5-97.5 percentiles with 95 % confidence intervals. A total of 2,011 (841 males, 1,170 females, mean age 18.6 (SD 0.6)) radiographs were analyzed. Sharp's angle was 38.8 {+-} 3.5 in males and 40.7 {+-} 3.5 in females, with 97.5 percentiles of 46 and 47 , respectively. The CE angle was 32.1 {+-} 6.1 in males and 31.0 {+-} 6.1 in females, with 2.5 percentiles of 21 and 20 , respectively. The FHEI was 86.0 % {+-} 6.3 % in males and 85.6 % {+-} 6.6 % in females, with 2.5 percentiles of 74 and 73 , respectively. Updated gender-specific reference ranges for radiographic measurements commonly used for hip dysplasia at skeletal maturity are reported, similar to or slightly wider than those described in the literature. Statistically significant gender differences have been confirmed for most of the measurements. (orig.)

  7. Postmortem retrieved canine THR: femoral and acetabular component interaction.

    Skurla, Carolyn P; James, Susan P


    Dogs are the preferred animal model for testing of human total hip replacements (THRs). A postmortem retrieval program for clinical, cemented, canine THR was established to analyze the long-term performance of THRs in dogs and to compare that performance to postmortem retrievals of human THRs. The purpose of the present study was to analyze the interaction between the femoral and acetabular components. Thirty-eight postmortem retrievals from 29 dogs were donated and analyzed. The acetabular components (ACs) were measured for volumetric wear and graded for articulating surface damage. Femoral and acetabular components were mechanically tested for implant stability. Digital image analysis was performed on contact radiographs of transverse femoral slices. Of 14 cases with a firmly implanted femoral component (FC). 6 articulated against loose ACs. Of 24 cases with a loose FC, 16 articulated against loose ACs. Only 4 specimens had both components firmly implanted, and 14 specimens had both components loose. There was a significant positive correlation between AC volumetric wear and FC loosening; however, there was no evidence of osteolysis or wear debris induced osteolysis as seen in human postmortem retrieval studies. There was a significant but weak negative correlation between FC loosening at the cement/bone interface and AC scores reflecting damage to the rim and creep across the entire AC. Although implant-on-implant damage to the AC was expected to positively correlate with FC loosening, this was not found. Researchers need to look at interactions between AC and FC to understand how the failure of one component affects performance of the other.

  8. Field calibration of cup anemometers

    Kristensen, L.; Jensen, G.; Hansen, A.; Kirkegaard, P.


    An outdoor calibration facility for cup anemometers, where the signals from 10 anemometers of which at least one is a reference can be recorded simultaneously, has been established. The results are discussed with special emphasis on the statistical significance of the calibration expressions. It is concluded that the method has the advantage that many anemometers can be calibrated accurately with a minimum of work and cost. The obvious disadvantage is that the calibration of a set of anemometers may take more than one month in order to have wind speeds covering a sufficiently large magnitude range in a wind direction sector where we can be sure that the instruments are exposed to identical, simultaneous wind flows. Another main conclusion is that statistical uncertainty must be carefully evaluated since the individual 10 minute wind-speed averages are not statistically independent. (au)

  9. [Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].

    Mai, J G; Gu, C; Lin, X Z; Li, T; Huang, W Q; Wang, H; Tan, X Y; Lin, H; Wang, Y M; Yang, Y Q; Jin, D D; Fan, S C


    Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all

  10. Axial Spondylometaphyseal Dysplasia Is Caused by C21orf2 Mutations.

    Zheng Wang

    Full Text Available Axial spondylometaphyseal dysplasia (axial SMD is an autosomal recessive disease characterized by dysplasia of axial skeleton and retinal dystrophy. We conducted whole exome sequencing and identified C21orf2 (chromosome 21 open reading frame 2 as a disease gene for axial SMD. C21orf2 mutations have been recently found to cause isolated retinal degeneration and Jeune syndrome. We found a total of five biallelic C21orf2 mutations in six families out of nine: three missense and two splicing mutations in patients with various ethnic backgrounds. The pathogenic effects of the splicing (splice-site and branch-point mutations were confirmed on RNA level, which showed complex patterns of abnormal splicing. C21orf2 mutations presented with a wide range of skeletal phenotypes, including cupped and flared anterior ends of ribs, lacy ilia and metaphyseal dysplasia of proximal femora. Analysis of patients without C21orf2 mutation indicated genetic heterogeneity of axial SMD. Functional data in chondrocyte suggest C21orf2 is implicated in cartilage differentiation. C21orf2 protein was localized to the connecting cilium of the cone and rod photoreceptors, confirming its significance in retinal function. Our study indicates that axial SMD is a member of a unique group of ciliopathy affecting skeleton and retina.

  11. Acetabular fractures: what radiologists should know and how 3D CT can aid classification.

    Scheinfeld, Meir H; Dym, Akiva A; Spektor, Michael; Avery, Laura L; Dym, R Joshua; Amanatullah, Derek F


    Correct recognition, description, and classification of acetabular fractures is essential for efficient patient triage and treatment. Acetabular fractures may result from high-energy trauma or low-energy trauma in the elderly. The most widely used acetabular fracture classification system among radiologists and orthopedic surgeons is the system of Judet and Letournel, which includes five elementary (or elemental) and five associated fractures. The elementary fractures are anterior wall, posterior wall, anterior column, posterior column, and transverse. The associated fractures are all combinations or partial combinations of the elementary fractures and include transverse with posterior wall, T-shaped, associated both column, anterior column or wall with posterior hemitransverse, and posterior column with posterior wall. The most unique fracture is the associated both column fracture, which completely dissociates the acetabular articular surface from the sciatic buttress. Accurate categorization of acetabular fractures is challenging because of the complex three-dimensional (3D) anatomy of the pelvis, the rarity of certain acetabular fracture variants, and confusing nomenclature. Comparing a 3D image of the fractured acetabulum with a standard diagram containing the 10 Judet and Letournel categories of acetabular fracture and using a flowchart algorithm are effective ways of arriving at the correct fracture classification. Online supplemental material is available for this article.




    Full Text Available BACKGROUND: The treatment of acetabular fractures has seen major advances in the field of orthopaedic traumatology. Conservative treatment of acetabular fractures leads to poor results. Newer diagnostic tools like the Computed Tomography (CT scan help in analyzing the three dimensional disturbance in the normal anatomy and plan the surgical management accordingly. In recent years operative treatment has become the treat ment of choice in the management of acetabular fractures as precise anatomical reduction with adequate internal fixation can be attained. OBJECTIVES : To evaluate the functional outcome of operatively managed acetabular fractures , and assess the efficacy of operative fixation of acetabular fractures , and also study the complications of operative fixation of acetabular fractures. MATERIALS AND METHODS: Fifty five patients (49 male & six female admitted to Sanjay Gandhi Institute of Trauma and Orthopaedics wi th acetabular fractures underwent open reduction and internal fixation. All patients were evaluated with Matta et al score with a minimum of follow up of six months. RESULTS: There were 24 (43.6% patients with bicolumnar fractures , 15(27.3% had posterior column fractures , 10(18.1% had posterior wall fractures , five (9.1% had transverse fractures , and one (1.8% patient had an anterior column fracture. Full weight bearing was attained in thirty five (63.6% patients in 16 weeks and in twenty (36.4% pati ents after 16 weeks. Forty five (81.8% patients were free of complications. According to Matta et al score 27(49.1% had excellent , 15(27.3% had good , nine (16.4% had fair , and four (7.3% had poor results. CONCLUSION: Open reduction and internal fixati on of acetabular fractures is a reliable technique , minimizes healing time and provides congruent joint reduction. Operative treatment of acetabular fractures results in predictable union and good clinical results with a low rate of complications.

  13. Acetabular orientation variability and symmetry based on CT scans of adults

    Lubovsky, Omri; Liebergall, Meir; Khoury, Amal [Hadassah-Hebrew University Medical Center, Orthopedic Surgery Complex, Jerusalem (Israel); Peleg, Eran [Hadassah-Hebrew University Medical Center, Department of Medical Engineering, Jerusalem (Israel); Joskowicz, Leo [Hebrew University of Jerusalem, School of Engineering and Computer Science, Jerusalem (Israel)


    Understanding acetabular orientation is important in many orthopaedic procedures. Acetabular orientation, usually described by anteversion and abduction angles, has uncertain measurement variability in adult patients. The goals of this study are threefold: (1) to describe a new method for computing patient-specific abduction/anteversion angles from a single CT study based on the identification of anatomical landmarks and acetabular rim points; (2) to quantify the inaccuracies associated with landmark selection in computing the acetabular angles; and (3) to quantify the variability and symmetry of acetabular orientation. A total of 25 CT studies from adult patients scanned for non-orthopaedic indications were retrospectively reviewed. The patients were randomly selected from the hospital's database. Inclusion criteria were adults 20-65 years of age. Acetabular landmark coordinates were identified by expert observers and tabulated in a spreadsheet. Two sets of calculations were done using the data: (1) computation of the abduction and anteversion for each patient, and (2) evaluation of the variability of measurements in the same individual by the same surgeon. The results were tabulated and summary statistics computed. This retrospective study showed that acetabular abduction and anteversion angles averaged 54 and 17 , respectively, in adults. A clinically significant intra-patient variability of >20 was found. We also found that the right and left side rim plane orientation were significantly correlated, but were not always symmetric. A new method of computing patient-specific abduction and anteversion angles from a CT study of the anterior pelvic plane and the left and right acetabular rim planes was reliable and accurate. We found that the acetabular rim plane can be reliably and accurately computed from identified points on the rim. The novelty of this work is that angular measurements are performed between planes on a 3-D model rather than lines on 2-D

  14. Acetabular fractures following rugby tackles: a case series

    Good, Daniel W


    Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

  15. Function after pelvic tumour resection involving the acetabular ring.

    Nilsonne, U; Kreicbergs, A; Olsson, E; Stark, A


    Seven patients subjected to pelvic tumour resection involving the acetabular ring were analyzed with respect to function. In addition to conventional clinical assessment gait was analyzed objectively by means of an electronic walk-way and residual hip-muscle power tested by means of a Cybex II dynamometer. Functional results reported by the patients with respect to pain, walking and working capacity appeared better than those elicited by clinical examination. All patients exhibited a marked pelvic tilt and a positive Trendelenburg sign. Only one patient walked without any kind of support. Leg-length discrepancy was on an average 6 cm. Objective gait analysis disclosed that all patients had reduced weight-bearing time on the operated side as compared to the non-operated. This, however, was clearly less pronounced for those patients who appeared best with respect to pain, walking and working capacity. These patients also showed the best hip extension power which appeared more important from a functional point of view than hip flexion and, surprisingly, hip abduction power. Radiographic examination showed that bony support for the proximal femur, provided either by the formation of a bone shelf from the remaining iliac bone or by the remaining iliac bone itself, was of decisive importance for function. The results of the present study show that pelvic tumour resection involving the acetabular ring, provided radical tumour removal can be achieved, constitutes a feasible alternative to hemipelvectomy from a functional point of view.

  16. Atypical periprosthetic acetabular fracture in long-term alendronate therapy

    Marongiu, Giuseppe; Capone, Antonio


    Summary Bisphosphonates have been commonly used in the treatment of osteoporosis, demonstrating its efficacy in fracture risk reduction. However, even if are generally safe and well tolerated, concerns have emerged about atypical fractures related to its prolonged use. Although atypical femoral fracture are more common, case reports demonstrated that even other skeletal areas can be involved by unusual pattern of fracture. We report a atypical acetabular periprosthetic fracture in a 83-year-old female patient after prolonged alendronate treatment for osteoporosis and isolated acetabular revision surgery. The patient underwent to clinical, bioumoral and radiological evaluation and all the history cases were fully reported. We believe this periprosthetic fracture, according to the available data, may have similar underlying pathology to atypical femoral fractures. Awareness of symptoms, in addition to a regular radiographic survey may facilitate early diagnosis and possible prevention of spontaneous periprosthetic fractures, in patients receiving bisphosphonate therapy beyond 5 years. The treatment of this atypical periprosthetic fracture should include both surgical than pharmacological therapy to obtained bone healing. PMID:28228784

  17. Clear plastic cups: a childhood choking hazard.

    Weiss, R L; Goldstein, M N; Dharia, A; Zahtz, G; Abramson, A L; Patel, M


    The disposable plastic beverage cup is not usually regarded as hazardous to young children. Certain varieties of these products however, are manufactured from a brittle, clear plastic that easily cracks and fragments. While most conscientious parents keep their children safe from peanuts, balloons, and other known choking hazards, a child can surreptitiously bite a cup edge and aspirate the fragment. We report two cases of foreign body aspiration involving clear plastic cups that went undetected one of which remained 21 months following a negative rigid bronchoscopy. Diagnostic difficulties are related to the transparency and radiolucency of these objects. When suspicious of foreign body aspiration in children, otolaryngologists should inquire about the availability of clear plastic cups in the household and be mindful of the diagnostic pitfalls. Further investigations including CT scanning and repeat bronchoscopy may be helpful in cases of suspected missed foreign bodies. An educational campaign aimed at prevention and placement of product package warning labels should be established.

  18. Does Cupping = Success for Olympic Athletes?

    ... news/fullstory_160301.html Does 'Cupping' = Success for Olympic Athletes? Telltale red circles of ancient Chinese practice ... Eyebrows raised in Rio over the weekend when Olympic athletes like swimmer Michael Phelps started showing up ...

  19. Some developments on cup anemometer aerodynamics

    Pindado Carrion, Santiago; Cubas Cano, Javier


    In the present study the geometry of cups is experimentally studied through anemometer performance. This performance is analyzed in two different ways. On the one hand the anemometer transfer function between cases is compared. On the other hand the stationary rotation speed is decomposed into constant and harmonic terms, the comparison being established between the last ones. Results indicate that some cup shapes can improve the uniformity of anemometer rotation, this fact being important to...

  20. [Study on the mechanisms of cupping therapy].

    Hong, Shou-Hai; Wu, Fei; Lu, Xuan; Cai, Qing; Guo, Yi


    Computerized literature searches are performed for articles of the mechanism of cupping therapy in the past 10 years. The mechanism of action of local negative pressure applied to human body is studied in terms of specific changes in local tissue structure, stretch to the nerve and muscle, increasing blood circulation and causing autohemolysis. This paper aims to explain the mechanism of cupping therapy according to modern science.

  1. Distance constant of the Risoe cup anemometer

    Kristensen, L.; Frost Hansen, O.


    The theory for cup-anemometer dynamics is presented in some detail and two methods of obtaining the distance constant . are discussed. The first method is based on wind tunnel measurements: with a constant wind speed the cup anemometer is released from a locked position of the rotor and the increasing rotation rate recorded. It is concluded that the rapid increase in rotation rate makes the method very inaccurate. The second method consists of an analysis of turbulent, atmospheric of wind speed as measured by the cup anemometer and a fast-responding sonic anemometer with a spatial eddy resolution which is significantly better than that which can be obtained by a cup anemometer. The ratio between the measured power spectra of the horizontal wind speed by the two instruments contains the necessary information for determining the response characteristics of the cup anemometer and thereby .. The conditions for this last method to be accurate are discussed. Field measurements are used to demonstrate how . is determined the Riso cup anemometer, model P2546.

  2. The "pirate sign" in fibrous dysplasia.

    Singnurkar, Amit; Rush, Chris


    Fibrous dysplasia commonly involves the skull in both its monostotic and polyostotic variants. We present two cases of fibrous dysplasia involving the sphenoid wing, which were strikingly similar in their bone scan appearance. Both patients demonstrated intense increased uptake of Tc-99m MDP in a pattern reminding us of a "pirate wearing an eyepatch." We propose that this characteristic appearance of fibrous dysplasia of the sphenoid wing be called the "pirate sign." A review of the literature revealed several other pathologic conditions that have been reported to involve the sphenoid bone and should be considered in the differential diagnosis of abnormal bone tracer uptake in this region.

  3. Posttraumatic Cranial Cystic Fibrous Dysplasia

    Arata Tomiyama


    Full Text Available A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp, computed tomography (CT, and magnetic resonance imaging (MRI showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD. The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.

  4. Renal infarction complicating fibromuscular dysplasia.

    Gavalas, M; Meisner, R; Labropoulos, N; Gasparis, A; Tassiopoulos, A


    Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects the renal and extracranial carotid arteries. We present 3 cases of renal infarction complicating renal artery FMD in 42-, 43-, and 46-year-old females and provide a comprehensive review of the literature on this topic. In our patients, oral anticoagulation therapy was used to treat all cases of infarction, and percutaneous angioplasty was used nonemergently in one case to treat refractory hypertension. All patients remained stable at 1-year follow-up. This is consistent with outcomes in previously published reports where conservative medical management was comparable to surgical and interventional therapies. Demographic differences may also exist in patients with renal infarction and FMD. A higher prevalence of males and a younger age at presentation have been found in these patients when compared to the general population with FMD.

  5. Ectodermal Dysplasia Skin Fragility Syndrome

    Ayça Alan Atalay


    Full Text Available Ectodermal dysplasia-skin fragility syndrome (EDSFS is a rare autosomal recessive genodermatosis first described in 1997 by Mc Grath. EDSFS results from loss of function mutations in plakophilin-1 (PKP1. PKP1 is a structural component of desmosomes, cellcell adhesion complexes. It is also found as a nuclear protein in several cell types that are lack of desmosomes. In skin, however, PKP1 expression is confined mainly to suprabasal keratinocytes and the outer root sheath of hair follicules. Loss of function mutation in PKP1 leads to extensive skin fragility, bullae and erosions following minor trauma, focal keratoderma with painful fissures, alopecia, and nail dystrophy. In some patients hypohidrosis may also be seen. EDSFS is now considered as a specific suprabasal form of epidermolysis bullosa simplex. In this report we describe a 20 year old EDSFS case.

  6. Developmental hip dysplasia in adolescence

    Vukašinović Zoran


    Full Text Available The authors define adolescence and developmental dysplasia of the hip (DDH. Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications. The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

  7. Camptomelic dysplasia: A case report

    Koš Radmila


    Full Text Available Campomelic/camptomelic dysplasia is a very rare, severe osteochondrodysplasia characterised by severe skeletal and nonskeletal malformations and lethal outcome mainly in neonatal period. Characteristic abnormality by which the syndrome got its name is short, bowed long bones of lower extremities, most often of femur, manifested by short and bowed legs. Skin dimpling on tibial anterior side is another prominent characteristic of this syndrome. Severe cases are inherited by autosomal dominant trait, by mutation Sox9 gene on chromosome 17, with lethal outcome in the first days of life. Less severe forms of the disease are due to balanced translocation t (13;17 with life span up to the third decade of life. A majority of karyotypic males present as phenotypic females. We report a case of a female neonate, without consanguinity between parents, with characteristic signs of camptomelic dysplasia with short birth length of 46 cm, macrocephaly (head circumference 39 cm, dolichocephaly, hydrocephalus, short trunk and legs. Narrow rib cage, bowed lower extremities, short hand and foot phalanges, nail hypoplasia were noticed. Anterior fontanelle was enlarged, high forehead, face small and flat, hypertelorism, low nasal bridge, micrognathia, low set ears, cleft palate, were found. Characteristic skin dimpling on anterior side of tibia was present on both legs. Bone X-ray studies presented the following changes: anterior bowing of shortened femurs, hip dislocation, cervical vertebrae, scapulas, eleven pairs of slender ribs. Hip luxation. Karyotype was normal for a female, 46 XX. Respiratory insufficiency was present since birth, exacerbated, and led to lethal outcome in the second day of life, as described in the majority of these patients. .

  8. Autologous Membrane Induced Chondrogenesis (AMIC) for the treatment of acetabular chondral defect

    Fontana, Andrea


    Summary Background Acetabular chondral defect are very frequently associated to FAI. Treatment options are still questionable. Methods Between 2008 and 2014, 201 patients over 583 have been arthroscopically treated with the AMIC procedure for grade III and/or IV acetabular chondral lesions. Patients age was between 18 and 50 years; acetabular chondral lesion size was between 2 and 4 cm2; radiological Tönnis degree of osteoarthritis was ≤ 2. Results The mean follow up of the entire group of 201 patients was 5 years (from 8 to 2). Significant improvement, as measured by the mHHS, was observed at 6 months in comparison to preoperative levels (80.3 ± 8.3) (prepair medium-sized chondral defects on the acetabular side of the hip found during treatment of FAI and lead to long-term favourable outcomes. Level of evidence IV. PMID:28066742

  9. A reduction clamp for an aiming component in associated acetabular fractures

    Zhang-Fu Wang


    Full Text Available Background: The treatment of acetabular fractures is complex and requires specialized equipment. However, all currently available instruments have some disadvantages. A new reduction clamp that can firmly enable reduction and not hinder subsequent fixation procedures for some special fracture types is needed. Materials and Methods: In this study, we introduce a new acetabular clamp and its preliminary clinical application in three T-shaped acetabular fractures. Results: This new clamp can successfully pull the posterior column back to the anterior column and firmly maintain the reduction. This clamp′s aiming plate can facilitate the insertion of long lag screws. The clamp is also easy to assemble and use. Conclusion: This reduction clamp is a useful instrument that can facilitate open reduction and internal fixation of acetabular fractures.

  10. Mandibuloacral Dysplasia in An Iranian Girl

    F. Abbasi


    Full Text Available Mandibuloacral dysplasia (MAD is a rare autosomal recessive syndrome. Less than 25 families have been reported, most of which are Italian. Here, we describe a new patient of Iranian origin, born to consanguineous parents.

  11. Numerical modelling of the pelvis and acetabular construct following hip arthroplasty

    Phillips, Andrew T. M.


    The study presents finite element models of the acetabular construct and the pelvis. Particular attention is given to investigating the behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique. Mechanical tests are carried out on bone graft, and constitutive models are developed to describe its non-linear elasto-plastic behaviour, for inclusion in finite element analyses. Impaction of bone graft was found to have...

  12. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng


    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.


    Venkatram Reddy


    Full Text Available Congenital radial dysplasia, also referred to as radial club hand , means deficiency along the preaxial or radial side of the extremity. It ranges from hypoplasia of the thumb to variou s degrees of radial hypoplasia. We present one such rare case of type 4 congenital unilateral isolated radial dysplasia with carpel anomaly , reported to our department in SVS medical C ollege, Mahabubanagar, Telangana state

  14. Bilateral anophthalmia with septo-optic dysplasia

    Manisha Jana


    Full Text Available Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral anophthalmia and septo-optic dysplasia.

  15. Radiologic analysis of femoral acetabular impingement: from radiography to MRI

    Dwek, Jerry R. [University of California at San Diego, Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); San Diego Imaging, San Diego, CA (United States); Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)


    Femoral acetabular impingement is a set of morphologic abnormalities that are considered to be a major cause of degenerative disease in the hip joint. Early changes are already present in adolescence when it is the pediatric radiologist who must assess current damage with the aim of averting progression to more severe and debilitating osteoarthritis. A multimodality approach is used for diagnosis, that includes conventional radiography and CT to assess the osseous structures. MR arthrography is the primary advanced imaging modality for assessment of morphologic changes as well as injuries of the labrum and articular cartilage. Details of radiologic imaging are offered to guide the radiologist and provide an avenue for the accurate description of the osseous and articular alterations and injury. (orig.)

  16. The concentric all-polyethylene Exeter acetabular component in primary total hip replacement.

    Veitch, S W; Whitehouse, S L; Howell, J R; Hubble, M J W; Gie, G A; Timperley, A J


    We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients (four hips) were lost to follow-up. Radiographs at the final review were available for 110 of the 122 surviving hips. There were acetabular radiolucent lines in 54 hips (49%). Two acetabular components had migrated but neither patient required revision. The Kaplan-Meier survivorship at 15 years with 61 hips at risk with revision for any cause as the endpoint was 89.9% (95% confidence interval (CI) 84.6 to 95.2) and for aseptic loosening of the acetabular component or lysis 91.7% (95% CI 86.6 to 96.8). In 210 hips with a diagnosis of primary osteoarthritis, survivorship with revision for any cause as the endpoint was 93.2% (95% CI 88.1 to 98.3), and for aseptic loosening of the acetabular component 95.0% (95% CI 90.3 to 99.7). The cemented all-polyethylene Exeter acetabular component has an excellent long-term survivorship.

  17. Value of 3-D CT in classifying acetabular fractures during orthopedic residency training.

    Garrett, Jeffrey; Halvorson, Jason; Carroll, Eben; Webb, Lawrence X


    The complex anatomy of the pelvis and acetabulum have historically made classification and interpretation of acetabular fractures difficult for orthopedic trainees. The addition of 3-dimensional (3-D) computed tomography (CT) scan has gained popularity in preoperative planning, identification, and education of acetabular fractures given their complexity. Therefore, the authors examined the value of 3-D CT compared with conventional radiography in classifying acetabular fractures at different levels of orthopedic training. Their hypothesis was that 3-D CT would improve correct identification of acetabular fractures compared with conventional radiography.The classic Letournel fracture pattern classification system was presented in quiz format to 57 orthopedic residents and 20 fellowship-trained orthopedic traumatologists. A case consisted of (1) plain radiographs and 2-dimensional axial CT scans or (2) 3-D CT scans. All levels of training showed significant improvement in classifying acetabular fractures with 3-D vs 2-D CT, with the greatest benefit from 3-D CT found in junior residents (postgraduate years 1-3).Three-dimensional CT scans can be an effective educational tool for understanding the complex spatial anatomy of the pelvis, learning acetabular fracture patterns, and correctly applying a widely accepted fracture classification system.

  18. 髋关节表面置换术治疗先天性髋关节发育不良%Hip resurfacing arthroplasty for secondary osteoarthrltis after developmental dysplasia of hip

    王琦; 张先龙; 蒋垚; 陈云苏; 沈灏; 邵俊杰


    Objective To study the clinical results of metal on metal hip resurfacing arthroplasty for developmental dysplasia patients.Methods From March 2005 to December 2006, 34 eases of developmental dysplasia patients ( Crowe Ⅰ , Crowe Ⅱ ) were attempted to have metal on metal hip resurfacing arthroplasty.There were 29 females (32 hips), 5 males (5 hips).The average age was 45 (26-57 ) years old.Radiographic and clinical evaluations were taken at 6 weeks, 3 months, 1 year and then once a year postoperatively.The average Harris score was 35 (25-44).Hip flexion was 101°, abduction 24°,adduction 15°.Results Three patients were turned to total hip arthroplasty during operations.Thirty-one patients (34 hips) received hip resurfacing surgery. These 31 patients were followed for average 21.4 months (12-33 months).The average Harris score was 94 (82-100) at the latest follow-up, and there was statistical difference compared with the preoperative score ( P < 0.01 ).Hip flexion increased to 133°,abduction to 48°, adduction to 26°.No radiolueency line was found at both acetabular and femoral sides in all the patients.The average abduction angle of acetabular cup was 43°(40°-53°) , and the average stern shaft angle was 139°(130°-145°).Conclusions The short term result is excellent.While the mid to long term results for hip resurfscing arthroplasty in developmental dysplasia patients are still looking forward, and the rneticulous surgical technique and strict patient selection are the key of the good results.%目的 探讨髋关节表面置换术治疗先天性髋关节发育不良的临床疗效.方法 2005年3月至2006年12月对34例(37髋)先天性髋关节发育不良患者行髋关节表面置换术,其中Crowe Ⅰ型28例(31髋)、Crowe Ⅱ型6例(6髋).其中女性29例(32髋),男性5例(5髋),患者平均年龄45岁(26~57岁).患者在术后6周、3个月、1年,及此后每年1次进行随访,接受放射学及临床

  19. Failure analysis of retrieved PE-UHMW acetabular liners.

    Laska, Anna; Archodoulaki, Vasiliki-Maria; Duscher, Bernadette


    Ultra-high molecular weight polyethylene (PE-UHMW) acetabular liners have a limited lifespan in a patient's body. There are many factors affecting the performance of the implant and furthermore the properties of the polymeric material are changing after implantation. In this work material changes according to structure and morphology and their implication on mechanical properties are in focus. The physical and mechanical properties of ten crosslinked (xL) PE-UHMW and nine conventional (conv) gamma-sterilized PE-UHMW hip components, used as sliding surface in total hip joint replacement, with different in-vivo times are compared. The evaluation of the retrieved acetabular liners is performed in view of crosslinking and conventional gamma-sterilization but also in terms of the influence of gender concerning alteration in properties. The oxidative degradation in the PE-UHMW is investigated by means of Fourier Transformed Infrared Spectroscopy (FTIR). The characterization of the morphology is carried out via differential scanning calorimetry (DSC). A depth profile of the micro-hardness and elastic modulus is taken over the cross-section of the components in order to find the influence of chemical constitution and morphology on the micro-mechanical properties. It could be shown that crosslinking and oxidative degradation influence the degree of crystallinity of the polymer. Oxidation occurs for both types of the material due to in-vivo time. Higher degree of crystallinity can be correlated to higher hardness and indentation modulus. No unequivocal superiority of crosslinked over conventional liners can be observed. The influence of sex concerning alteration of the evaluated properties matters but need to be further investigated.

  20. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Espandar R


    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  1. Quantitative Computerized Assessment of the Degree of Acetabular Bone Deficiency: Total radial Acetabular Bone Loss (TrABL

    Frederik Gelaude


    Full Text Available A novel quantitative, computerized, and, therefore, highly objective method is presented to assess the degree of total radical acetabular bone loss. The method, which is abbreviated to “TrABL”, makes use of advanced 3D CT-based image processing and effective 3D anatomical reconstruction methodology. The output data consist of a ratio and a graph, which can both be used for direct comparison between specimens. A first dataset of twelve highly deficient hemipelves, mainly Paprosky types IIIB, is used as illustration. Although generalization of the findings will require further investigation on a larger population, it can be assumed that the presented method has the potential to facilitate the preoperative use of existing classifications and related decision schemes for treatment selection in complex revision cases.

  2. Abordagem cirúrgica inédita para denervação acetabular em cães A new surgical approach to acetabular denervation in dogs

    Cássio R.A. Ferrigno


    Full Text Available Este artigo tem por objetivo demonstrar nova abordagem cirúrgica para denervação seletiva das fibras sensitivas do periósteo acetabular, para tratamento da displasia coxo femoral em cães, conduzidas em 189 articulações. Para tanto, é descrita abordagem da região cranial e dorso-lateral do acetábulo de cães por incisão em forma de meia lua de aproximadamente de três centímetros de extensão, iniciando trocânter maior do fêmur e em direção ao corpo do ílio. Após rebatimento dorsal do músculo glúteo médio, secciona-se parcialmente a inserção do m. glúteo profundo para acesso às regiões citadas. Com auxílio de cureta foi removido, em todos os pacientes, periósteo na margem acetabular cranial e dorso lateral, até a exposição da cortical óssea. Em todos os animais foi possível a abordagem, tanto da face cranial como também acesso para a curetagem da face dorsal do acetábulo, com a técnica descrita, com incisão de pele de aproximadamente 3,2cm. A curetagem da porção cranial do acetábulo foi, em todos os casos realizados, sem visualização do osso, mas de fácil confecção e sem intercorrências de lesão de nervos ou músculos. Em todas as abordagens foi possível visualizar a cápsula articular da articulação coxo femoral, e em nenhum dos animais esta estrutura foi incisada por erro de técnica. Conclui-se que a abordagem cirúrgica descrita no presente trabalho é factível para este tipo de procedimento cirúrgico em cães, promovendo acesso adequado, com mínima invasão e sem complicações de qualquer natureza.The purpose of this study is to demonstrate a new surgical approach for the selective denervation of the sensitive fibers of the acetabular periosteum, for the treatment of hip dysplasia in dogs, conducted in 189 joints.The surgical approach of the cranial and dorso-lateral regions of the acetabular joint in dogs, by moon-shaped incision of approximately 3cm in extension, starting from the

  3. An updated review of the efficacy of cupping therapy.

    Huijuan Cao

    Full Text Available BACKGROUND: Since 1950, traditional Chinese medicine (TCM cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic literature review of clinical studies on cupping therapy, this study presents a thorough review of randomized controlled trials (RCTs to evaluate the therapeutic effect of cupping therapy. METHOD: Six databases were searched for articles published through 2010. RCTs on cupping therapy for various diseases were included. Studies on cupping therapy combined with other TCM treatments versus non-TCM therapies were excluded. RESULTS: 135 RCTs published from 1992 through 2010 were identified. The studies were generally of low methodological quality. Diseases for which cupping therapy was commonly applied were herpes zoster, facial paralysis (Bell palsy, cough and dyspnea, acne, lumbar disc herniation, and cervical spondylosis. Wet cupping was used in most trials, followed by retained cupping, moving cupping, and flash cupping. Meta-analysis showed cupping therapy combined with other TCM treatments was significantly superior to other treatments alone in increasing the number of cured patients with herpes zoster, facial paralysis, acne, and cervical spondylosis. No serious adverse effects were reported in the trials. CONCLUSIONS: Numerous RCTs on cupping therapy have been conducted and published during the past decades. This review showed that cupping has potential effect in the treatment of herpes zoster and other specific conditions. However, further rigorously designed trials on its use for other conditions are warranted.

  4. Wear and migration of highly cross-linked and conventional cemented polyethylene cups with cobalt chrome or Oxinium femoral heads: a randomized radiostereometric study of 150 patients.

    Kadar, Thomas; Hallan, Geir; Aamodt, Arild; Indrekvam, Kari; Badawy, Mona; Skredderstuen, Arne; Havelin, Leif Ivar; Stokke, Terje; Haugan, Kristin; Espehaug, Birgitte; Furnes, Ove


    This randomized study was performed to compare wear and migration of five different cemented total hip joint articulations in 150 patients. The patients received either a Charnley femoral stem with a 22.2 mm head or a Spectron EF femoral stem with a 28 mm head. The Charnley articulated with a γ-sterilized Charnley Ogee acetabular cup. The Spectron EF was used with either EtO-sterilized non-cross-linked polyethylene (Reflection All-Poly) or highly cross-linked (Reflection All-Poly XLPE) cups, combined with either cobalt chrome (CoCr) or Oxinium femoral heads. The patients were followed with repeated RSA measurements for 2 years. After 2 years, the EtO-sterilized non-cross-linked Reflection All-Poly cups had more than four times higher proximal penetration than its highly cross-linked counterpart. Use of Oxinium femoral heads did not affect penetration at 2 years compared to heads made of CoCr. Further follow-up is needed to evaluate the benefits, if any, of Oxinium femoral heads in the clinical setting. The Charnley Ogee was not outperformed by the more recently introduced implants in our study. We conclude that this prostheses still represents a standard against which new implants can be measured.

  5. ACCUWIND - Methods for classification of cup anemometers

    Dahlberg, J.-Å.; Friis Pedersen, Troels; Busche, P.


    Errors associated with the measurement of wind speed are the major sources of uncertainties in power performance testing of wind turbines. Field comparisons of well-calibrated anemometers show significant and not acceptable difference. The EuropeanCLASSCUP project posed the objectives to quantify...... the errors associated with the use of cup anemometers, and to develop a classification system for quantification of systematic errors of cup anemometers. This classification system has now been implementedin the IEC 61400-12-1 standard on power performance measurements in annex I and J. The classification...... of cup anemometers requires general external climatic operational ranges to be applied for the analysis of systematic errors. A Class A categoryclassification is connected to reasonably flat sites, and another Class B category is connected to complex terrain, General classification indices are the result...

  6. Developmental dysplasia of the hip

    Shahryar Noordin


    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  7. World Cup:Brands Gamble Began


    As I click the first word on board,eight days,17 hours and one minute later,the 2010 FIFA World Cup South AfricaTM would star t its month-long competition.Who would like to be awarded the World Cup Trophy at last has already aroused the enthusiasm of the whole world.Furthermore,the worldwide famous sports brands also have launched their adventure to bet which team they sponsored would be at the top of the competition.One month later,we could know who will win eventually.

  8. Fast-response cup anemometer features cosine response

    Frenzen, P.


    Six-cup, low-inertia anemometer combines high resolution and fast response with a unique ability to sense only the horizontal component of the winds fluctuating rapidly in three dimensions. Cup assemblies are fabricated of expanded polystyrene plastic.

  9. Football business models: Why did Germany win the World Cup?

    Cortsen, Kenneth


    This article looks into the managerial aspects related to why and how Germany won the 2014 FIFA World Cup.......This article looks into the managerial aspects related to why and how Germany won the 2014 FIFA World Cup....

  10. An Updated Review of the Efficacy of Cupping Therapy

    Huijuan Cao; Xun Li; Jianping Liu


    BACKGROUND: Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic literature review of clinical studies on cupping therapy, this study presents a thorough review of randomized controlled trials (RCTs) to evaluate the therapeutic effect of cupping therapy. METHOD: Six databases were searched for articles published through 2010. RCTs on cupping therapy for vari...

  11. Etiology and pathogenesis of ectodermal dysplasias.

    Itin, Peter H


    Ectodermal dysplasias are a large group of heterogeneous heritable conditions characterized by congenital defects of one or more ectodermal structures and their appendages. The skin and its appendages are mainly composed by ectodermal components but development initiation of appendages is orchestrated by signals of the mesoderm with the help of placodes. A complex network of signaling pathways coordinates the formation and function of ectodermal structures. In recent years much has been discovered regarding the molecular mechanisms of ectodermal embryogenesis and this facilitates a rational basis for classification of ectodermal dysplasia. Interestingly, not only complex ectodermal syndromes but also mono- or oligosymptomatic ectodermal malformations may result from a mutation in a gene that is critical for ectodermal development. Mesodermal, and occasionally endodermal malformations may coexist. Embryogenesis occurs in distinct tissue organizational fields and specific interactions among the germ layers exist that may lead to a wide range of ectodermal dysplasias. Of the approximately 200 different ectodermal dysplasias, about 80 have been characterized at the molecular level with identification of the genes that are mutated in these disorders. Modern molecular genetics will increasingly elucidate the basic defects of these distinct syndromes and shed more light into the regulatory mechanisms of embryology. The upcoming classification of ectodermal dysplasias will combine detailed clinical and molecular knowledge.

  12. Fibrous dysplasia of bone: a clinicopathologic review

    Mohan H


    Full Text Available Harsh Mohan1, Preeti Mittal1, Irneet Mundi1, Sudhir Kumar21Department of Pathology, 2Department of Orthopedics, Government Medical College, Sector 32, Chandigarh, IndiaAbstract: Fibrous dysplasia of the bones is an uncommon congenital skeletal disorder that is found equally in both genders and is not inherited. Its etiology has been linked to an activating mutation of Gsα and the downstream effects of the resultant increase in cAMP. Fibrous dysplasia is categorized as either monostotic or polyostotic, and may occur as a component of McCune-Albright syndrome or the rare Mazabraud syndrome. Long bones, skull bones, and ribs are the most commonly affected bones. The radiological picture is somewhat variable, including a ground-glass appearance, expansion of the bone, and sclerosis surrounding the lesion. Histologically, fibrous dysplasia shows irregularly-shaped trabeculae of immature, woven bone in a background of variably cellular, loosely arranged fibrous stroma. It may be complicated by pathologic fracture, and rarely by malignant transformation. This review examines interesting issues surrounding the etiology of fibrous dysplasia, its clinical and laboratory manifestations, radiological picture, utility of bone biopsy, gross and microscopic pathology, complications, and its differential diagnostic considerations.Keywords: fibrous dysplasia, McCune-Albright syndrome, monostotic form, polyostotic form

  13. Cup products in Hopf cyclic cohomology with coefficients in contramodules

    Rangipour, Bahram


    We use stable anti Yetter-Drinfeld contramodules to improve the cup products in Hopf cyclic cohomology. The improvement fixes the lack of functoriality of the cup products previously defined and show that the cup products are sensitive to the coefficients.

  14. Improved analytical method to study the cup anemometer performance

    Pindado, Santiago; Ramos-Cenzano, Alvaro; Cubas, Javier


    The cup anemometer rotor aerodynamics is analytically studied based on the aerodynamics of a single cup. The effect of the rotation on the aerodynamic force is included in the analytical model, together with the displacement of the aerodynamic center during one turn of the cup. The model can be fitted to the testing results, indicating the presence of both the aforementioned effects.

  15. Recycling disposable cups into paper plastic composites.

    Mitchell, Jonathan; Vandeperre, Luc; Dvorak, Rob; Kosior, Ed; Tarverdi, Karnik; Cheeseman, Christopher


    The majority of disposable cups are made from paper plastic laminates (PPL) which consist of high quality cellulose fibre with a thin internal polyethylene coating. There are limited recycling options for PPLs and this has contributed to disposable cups becoming a high profile, problematic waste. In this work disposable cups have been shredded to form PPL flakes and these have been used to reinforce polypropylene to form novel paper plastic composites (PPCs). The PPL flakes and polypropylene were mixed, extruded, pelletised and injection moulded at low temperatures to prevent degradation of the cellulose fibres. The level of PPL flake addition and the use of a maleated polyolefin coupling agent to enhance interfacial adhesion have been investigated. Samples have been characterised using tensile testing, dynamic mechanical analysis (DMA) and thermogravimetric analysis. Use of a coupling agent allows composites containing 40 wt.% of PPL flakes to increase tensile strength of PP by 50% to 30 MPa. The Young modulus also increases from 1 to 2.5 GPa and the work to fracture increases by a factor of 5. The work demonstrates that PPL disposable cups have potential to be beneficially reused as reinforcement in novel polypropylene composites.

  16. Orienteering World Cup hosted by CERN Club

    Katarina Anthony


    Elite runners took to the streets of Geneva for the last leg of the Orienteering World Cup, from 8-10 October. The Geneva finals were hosted by the CERN Orienteering Club and concluded months of competitions held across 5 countries.   Women's World-Cup winner, Simone Niggli (centre).  © Ilknur Colak The final events of the Orienteering World Cup took place in the Old Town of Geneva and Saint-Cergue, with runners following routes prepared by the CERN Orienteering Club. Orienteering is a sport of navigation, using only a compass, map and your sense of direction. The objective is to get to all the points on the map as quickly as possible, choosing your own paths as you run. This was the CERN club’s first successful participation in the World Cup, cementing its reputation as a fixture in the international orienteering world. Orienteering is not your typical Swiss pastime. Developed in Scandinavia, the sport has been gaining popularity internationally. “...

  17. Fast Faraday Cup With High Bandwidth

    Deibele, Craig E [Knoxville, TN


    A circuit card stripline Fast Faraday cup quantitatively measures the picosecond time structure of a charged particle beam. The stripline configuration maintains signal integrity, and stitching of the stripline increases the bandwidth. A calibration procedure ensures the measurement of the absolute charge and time structure of the charged particle beam.

  18. ACCUWIND - Methods for classification of cup anemometers

    Dahlberg, J.Aa.; Friis Pedersen, T.; Busche, P.


    Errors associated with the measurement of wind speed are the major sources of uncertainties in power performance testing of wind turbines. Field comparisons of well-calibrated anemometers show significant and not acceptable difference. The European CLASSCUP project posed the objectives to quantify the errors associated with the use of cup anemometers, and to develop a classification system for quantification of systematic errors of cup anemometers. This classification system has now been implemented in the IEC 61400-12-1 standard on power performance measurements in annex I and J. The classification of cup anemometers requires general external climatic operational ranges to be applied for the analysis of systematic errors. A Class A category classification is connected to reasonably flat sites, and another Class B category is connected to complex terrain, General classification indices are the result of assessment of systematic deviations. The present report focuses on methods that can be applied for assessment of such systematic deviations. A new alternative method for torque coefficient measurements at inclined flow have been developed, which have then been applied and compared to the existing methods developed in the CLASSCUP project and earlier. A number of approaches including the use of two cup anemometer models, two methods of torque coefficient measurement, two angular response measurements, and inclusion and exclusion of influence of friction have been implemented in the classification process in order to assess the robustness of methods. The results of the analysis are presented as classification indices, which are compared and discussed. (au)

  19. Joint space width in dysplasia of the hip

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K;


    In a longitudinal case-control study, we followed 81 subjects with dysplasia of the hip and 136 control subjects without dysplasia for ten years assessing radiological evidence of degeneration of the hip at admission and follow-up. There were no cases of subluxation in the group with dysplasia. N...

  20. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.


    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  1. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.


    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  2. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

    Magill, Paul


    Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

  3. Turner's syndrome, fibromuscular dysplasia, and stroke.

    Lancman, M; Mesropian, H; Serra, P; Granillo, R


    We report a 43-year-old woman who presented with a right frontoparietotemporal ischemic stroke. She had been diagnosed with Turner's syndrome during childhood and had a history of chronic estrogen therapy. Cerebral angiography showed lesions characteristics of fibromuscular dysplasia involving the right internal carotid and right vertebral arteries. We are not aware of any previous reports describing an association between fibromuscular dysplasia and Turner's syndrome. Although chronic estrogen therapy cannot be ruled out as a cause of this patient's stroke, we suggest a possible etiologic relation between these two entities.

  4. Cleido cranial dysplasia: report of a family.

    González López, Blanca Silvia; Ortiz Solalinde, Clara; Kubodera Ito, Toshio; Lara Carrillo, Edith; Ortiz Solalinde, Estela


    A family case of Cleidocranial Dysplasia is presented. A mother and two adolescent girls were examined. In all three cases, a radiological series was performed over the entire body. Generalized dysplasia in bones, prolonged retention of primary teeth, and delayed eruption of permanent, as well as supernumerary teeth was diagnosed. The citogenetic study with GTG band showed normal 46, XX. Bilateral audiometry in the mother demonstrated a mild to moderate hypoacustic condition. Radiological findings are presented and the importance of early diagnosis is discussed.

  5. A Procedure for Classification of Cup-Anemometers

    Friis Pedersen, Troels; Paulsen, Uwe Schmidt


    The paper proposes a classification procedure for cup-anemometers based on similar principles as for power converters. A range of operational parameters are established within which the response of the cup-anemometer is evaluated. The characteristics of real cup-anemometers are fitted...... to a realistic 3D cup-anemometer model. Afterwards, the model is used to calculate the response under the range of operational conditions which are set up for the classification. Responses are compared to the normal linear calibration relationship, derived from Wind tunnel calibrations. Results of the 3D cup-anemometer...

  6. Shape variability of the adult human acetabulum and acetabular fossa related to sex and age by geometric morphometrics. Implications for adult age estimation.

    San-Millán, Marta; Rissech, Carme; Turbón, Daniel


    This study aims to explore shape variability of the acetabulum during the human adult life span, in relation to sex and age. The human acetabular shape was analysed in 682 os coxae from three different documented skeletal collections from the Iberian Peninsula. Two landmarks and thirty-two sliding semi-landmarks were used for the geometric morphometric procedures and a clock-wise standard was used for orientation. The 180° meridian (6:00) line was positioned over the midpoint of the acetabular notch and 36 reference points in 10° increments along the rim were marked. Data showed that size, sex and age significantly influence acetabular shape variation. Sex differences were significant in individuals younger than 65 years old and were characterised by males exhibiting relatively extended acetabular rim profiles from 10:00 to 1:00, narrower acetabular notches, and reduced acetabular fossae. In addition, three main age-related changes occurred to the acetabular shape in both sexes: outer acetabular profile modification, with extension from 10:00 to 1:00 and reduction from 7:00 to 9:00, acetabular notch narrowing, and acetabular fossa reduction. The age-related changes that were observed are shared by both sexes and seem to be related to bone production associated with age. Specifically, age appears to affect the entire border of the lunate surface: the acetabular rim, both acetabular horns, and the outer edge of the acetabular fossa. Furthermore, shape data confirmed the clover-leaf shape of the acetabular fossa in both males and females. These results improve our understanding of acetabular shape, and assist in refining age-estimation methods and enhancing hip surgery and rehabilitation.

  7. Oxidation and other property changes of retrieved sequentially annealed UHMWPE acetabular and tibial bearings.

    Reinitz, Steven D; Currier, Barbara H; Van Citters, Douglas W; Levine, Rayna A; Collier, John P


    This investigation analyzed retrieved sequentially crosslinked and annealed (SXL) ultra-high molecular weight polyethylene bearings to determine whether the material is chemically stable in vivo. A series of retrieved tibial and acetabular components were analyzed for changes in ketone oxidation, crosslink density, and free radical concentration. Oxidation was observed to increase with in vivo duration, and the rate of oxidation in tibial inserts was significantly greater than in acetabular liners. SXL acetabular bearings oxidized at a rate comparable to gamma-sterilized liners, while SXL tibial inserts oxidized at a significantly faster rate than their gamma-sterilized counterparts. A significant decrease in crosslink density with increased mean ketone oxidation index was observed, suggesting that in vivo oxidation may be causing material degradation. Furthermore, a subsurface whitened damage region was also found in a subset of the bearings, indicating the possibility of a clinically relevant decrease in mechanical properties of these components.

  8. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.


    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  9. The Bone Dysplasia Ontology: integrating genotype and phenotype information in the skeletal dysplasia domain

    Groza Tudor


    Full Text Available Abstract Background Skeletal dysplasias are a rare and heterogeneous group of genetic disorders affecting skeletal development. Patients with skeletal dysplasias suffer from many complex medical issues including degenerative joint disease and neurological complications. Because the data and expertise associated with this field is both sparse and disparate, significant benefits will potentially accrue from the availability of an ontology that provides a shared conceptualisation of the domain knowledge and enables data integration, cross-referencing and advanced reasoning across the relevant but distributed data sources. Results We introduce the design considerations and implementation details of the Bone Dysplasia Ontology. We also describe the different components of the ontology, including a comprehensive and formal representation of the skeletal dysplasia domain as well as the related genotypes and phenotypes. We then briefly describe SKELETOME, a community-driven knowledge curation platform that is underpinned by the Bone Dysplasia Ontology. SKELETOME enables domain experts to use, refine and extend and apply the ontology without any prior ontology engineering experience--to advance the body of knowledge in the skeletal dysplasia field. Conclusions The Bone Dysplasia Ontology represents the most comprehensive structured knowledge source for the skeletal dysplasias domain. It provides the means for integrating and annotating clinical and research data, not only at the generic domain knowledge level, but also at the level of individual patient case studies. It enables links between individual cases and publicly available genotype and phenotype resources based on a community-driven curation process that ensures a shared conceptualisation of the domain knowledge and its continuous incremental evolution.

  10. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    Dandachli, Wael; Najefi, Ali; Iranpour, Farhad; Lenihan, Jonathan; Hart, Alister; Cobb, Justin [Imperial College London, Charing Cross Hospital, Department of Orthopaedic Surgery, London (United Kingdom)


    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  11. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)


    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  12. Backside Wear Analysis of Retrieved Acetabular Liners with a Press-Fit Locking Mechanism in Comparison to Wear Simulation In Vitro

    Ana Laura Puente Reyna


    Full Text Available Backside wear due to micromotion and poor conformity between the liner and its titanium alloy shell may contribute to the high rates of retroacetabular osteolysis and consequent aseptic loosening. The purpose of our study was to understand the wear process on the backside of polyethylene liners from two acetabular cup systems, whose locking mechanism is based on a press-fit cone in combination with a rough titanium conical inner surface on the fixation area. A direct comparison between in vitro wear simulator tests (equivalent to 3 years of use and retrieved liners (average 13.1 months in situ was done in order to evaluate the backside wear characteristics and behavior of these systems. Similar wear scores between in vitro tested and retrieved liners were observed. The results showed that this locking mechanism did not significantly produce wear marks at the backside of the polyethylene liners due to micromotion. In all the analyzed liners, the most common wear modes observed were small scratches at the cranial fixation zone directly below the rough titanium inner surface of the shell. It was concluded that most of the wear marks were produced during the insertion and removal of the liner, rather than during its time in situ.

  13. The other hip in unilateral hip dysplasia

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld


    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with app...

  14. MR findings of the osteofibrous dysplasia

    Jung, Joon Yong; Jee, Won Hee [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Hong, Sung Hwan [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); and others


    The aim of this study was to describe MR findings of osteofibrous dysplasia. MR images of 24 pathologically proven osteofibrous dysplasia cases were retrospectively analyzed for a signal intensity of the lesion, presence of intralesional fat signal, internal hypointense band, multilocular appearance, cortical expansion, intramedullary extension, cystic area, cortical breakage and extraosseous extension, abnormal signal from the adjacent bone marrow and soft tissue and patterns of contrast enhancement. All cases of osteofibrous dysplasia exhibited intermediate signal intensity on T1-weighted images. On T2-weighted images, 20 and 4 cases exhibited heterogeneously intermediate and high signal intensity, respectively. Intralesional fat was identified in 12% of the cases. Internal low-signal bands and multilocular appearance were observed in 91%. Cortical expansion was present in 58%. Intramedullary extension was present in all cases, and an entire intramedullary replacement was observed in 33%. Cortical breakage (n 3) and extraosseous mass formation (n = 1) were observed in cases with pathologic fractures only. A cystic area was observed in one case. Among 21 cases without a pathologic fracture, abnormal signal intensity in the surrounding bone marrow and adjacent soft tissue was observed in 43% and 48%, respectively. All cases exhibited diffuse contrast enhancement. Osteofibrous dysplasia exhibited diverse imaging features ranging from lesions confined to the cortex to more aggressive lesions with complete intramedullary involvement or perilesional marrow edema.

  15. Optic nerve decompression for orbitofrontal fibrous dysplasia.

    Abe, Takumi; Sato, Kaneshige; Otsuka, Takaharu; Kawamura, Noriyoshi; Shimazu, Motohiko; Izumiyama, Hitoshi; Matsumoto, Kiyoshi


    Orbitofrontal fibrous dysplasia often involves the bony orbit and the optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual distrubances, optic nerve decompression in patients without clinical signs of optic neuropathy is still controversial. We describe two patients with orbitofrontal fibrous dysplasia without signs of visual disturbance and one patient with McCune-Albright syndrome and progressive visual impairment. Optic nerve decompression was performed prophylactically for two patients and therapeutically for one patient through the transcranial extradural route. Dystopias and craniofacial deformities induced by fibrous dysplasia also were corrected. The micropressure suction-irrigation system was especially effective for decreasing heat transfer and thereby preventing thermal injury of the optic nerve. The orbitofrontal area was reconstructed from cranial bone, iliac bone, and ribs. Postoperative follow-up revealed no disturbances in visual function and no evidence of cerebrospinal fluid leakage. These findings suggest that optic nerve decompression may be effective in preventing visual disturbances with minimal risk of other neurological sequelae. Subsequent orbital reconstruction yielded satisfactory cosmetic results.

  16. Prophylactic intramedullary nailing in monostotic fibrous dysplasia.

    Demiralp, Bahtiyar; Ozturk, Cagatay; Ozturan, Kutay; Sanisoglu, Yavuz S; Cicek, Ilker E; Erler, Kaan


    Fibrous dysplasia of bone is an enigma with no known cure. Treatment currently consists of curettage and bone-grafting in an attempt to eradicate the lesion and to prevent progressive deformity. This study presents the results of prophylactic intramedullary nailing in 10 patients with monostotic fibrous dysplasia, pain increasing with movement, and scintigraphically established activity. Ten patients with monostotic fibrous dysplasia in their upper or lower extremities treated between 2001 and 2003 were included in the study. Seven patients were male and 3 were female; their mean age was 26.9 years. The mean duration of follow-up was 33.5 months. Closed intramedullary nail without reaming was used in all cases. Bone grafting was not performed. Patients were allowed full weight bearing on the affected extremities on the second postoperative day. Mean VAS for functional pain was 5.33 +/- 0.65 preoperatively and 2.26 +/- 0.57 at final follow-up (p < 0.05). Radiographs showed no changes in lesion size, and the intramedullary fixation appeared to be stable. Prophylactic intramedullary nailing appeared to be beneficial in monostotic fibrous dysplasia with scintigraphically proven activity and functional pain. It also avoids problems that may occur following pathological fracture.

  17. Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child

    Chun, K.A. [The Catholic University of Korea Uijongbu St. Mary' s Hospital, Department of Radiology, Uijongbu, Kyunggi-Do 480-130 (Korea); University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States); Morcuende, J. [University of Iowa Hospitals and Clinics, Department of Orthopaedic Surgery, Iowa City (United States); El-Khoury, G.Y. [University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States)


    In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

  18. Displaced Anterior Column Acetabular Fracture: Closed Reduction and Percutaneous CT-Navigated Fixation

    Huegli, R.W.; Staedele, H.; Messmer, P.; Regazzoni, P.; Steinbrich, W.; Gross, T. [Univ. Hospital of Basel (Switzerland). Dept. of Radiology


    The purpose of this study is to demonstrate the feasibility of computer-tomography-navigated closed reduction and percutaneous fixation (CRPF) in a patient with an externally rotated left acetabular fracture. After a follow-up of 18 months the patient was pain-free and had a normal range of motion in both hip joints. Radiologically, the fracture was fully consolidated, remodelled, and there were no signs of osteoarthritis. To our knowledge, CT-navigated CRPF of a rotated acetabular fracture has not been reported before. Further studies regarding the feasibility of the method are warranted(CRPF)

  19. Thin hard crest on the edge of ceramic acetabular liners accelerates wear in edge loading.

    Sanders, Anthony P; Dudhiya, Parth J; Brannon, Rebecca M


    Ceramic acetabular liners may exhibit a small, sharp crest-an artifact of discontinuous machining steps--at the junction between the concave spherical surface and the interior edge. On 3 ceramic liners, this crest was found to form a 9° to 11° deviation from tangency. Edge loading wear tests were conducted directly on this crest and on a smoother region of the edge. The crest elicited 2 to 15 times greater volumetric wear on the femoral head. The propensity of the crest to rapidly (machining protocols might be a root cause of stripe wear and squeaking in ceramic acetabular bearings.

  20. 人工全髋关节置换术中髋臼骨缺损的重建%Reconstruction of acetabular bone deficiency in total hip arthroplasty

    杨波; 林进; 翁习生; 金今; 赵庆; 邱贵兴


    Objective To discuss the characteristics and reconstruction strategies of acetabular bone deficiency in total hip arthroplasty in order to find the optimal resolution for this clinical puzzle. Methods Clinical and radiological materials of 37 patients (37 hips) with acetabular deficiency who underwent primary or revision total hip arthreplasty were analyzed retrospectively from May 1998 to August 2008. According to the common classification system for acetabular bone deficiency-the AAOS classification system, the acetabular bone defect was reconstructed using morsellized or structural bone grafting, accessory acetabular hardware (ring, cup or cage) together with cemented or cementless acetabular component respectively. All patients were followed up regularly to assess their hip function improvement by measuring the Harris hip score and to find out the grafting bone healing, absorption and position of the prosthesis by plain radiographic examination. Results There were 11 primary and 26 revision total hip arthroplasty. There were 9 hips of AAOS-type Ⅰ defect, 13 of type Ⅱ and 15 of type Ⅲ. Morsollized bone grafting was used in 24 cases, bulk structural bone grafting in 6 cases and mixed bone grafting in 7 cases. Twenty-one patients used cementless prosthesis and 16 used cemented prosthesis. The average follow-up period was 53.7 months (6.5 to 130.5 months), the average preoperative Harris hip score was 42±8 with contrast to 87±5 of post-operation. Statistically significant difference was found according to t-test with P value less than 0.05. Major or complete healing of grafting bone was obtained at the latest follow-up. Conclusions Acetabular bone defect during primary or revision total hip arthroplasty should be reconstructed according to its characteristics and severity. For relatively simple AAOS type Ⅰ and type Ⅱ cases, morsellized or bulk structural bone grafting together with cementless prosthesis could achieve favorable initial stability, but for

  1. Flow distortion on boom mounted cup anemometers

    Lindelöw, Per Jonas Petter; Friis Pedersen, Troels; Gottschall, Julia

    In this report we investigate on wind direction dependent errors in the measurement of the horizontal wind speed by boom mounted cup anemometers. The boom mounting on the studied lattice tower is performed according to IEC standard design rules, yet, larger deviations than predicted by flow models...... are observed. The errors on the measurements are likely caused by an underestimation of the flow distortions around the tower. In this paper an experimental method for deriving a correction formula and an in-field calibration is suggested. The method is based on measurements with two cup anemometers mounted...... in the measurement of wind turbine power performance, wind resource assessment and for providing purposeful in-field comparisons between different sensors, e.g. lidar anemometers. With the proposed method, direction dependent errors can be extracted and the mast flow distortion effect on the wind measurements...

  2. Analysis of Earing in Deep Drawn Cups

    Aretz, Holger; Aegerter, Johannes; Engler, Olaf


    The cup-drawing of a strongly anisotropic sheet metal is simulated using a commercial finite element software along with a user material subroutine. In order to accurately describe the plastic anisotropy of the material the well-known recent yield function `Yld2004-18p' is extended. Regarding the experimental characterization of the considered material the occurrence of dynamic strain aging lead to an oscillating signal of the width change of the tensile samples, which prevented a reliable determination of plastic strain ratios (r-values). Thus, an improved measurement concept was developed that leads to a very robust and reproducible determination of r-values. Furthermore, a novel plane-strain tensile test sample is presented which is used for the characterization of the plastic anisotropy in biaxial loading states. A quantitative comparison with measured earing profiles of deep drawn cups illustrates the predictive capabilities of the numerical simulation.

  3. Sampling Bias on Cup Anemometer Mean Winds

    Kristensen, L.; Hansen, O. F.; Højstrup, J.


    The cup anemometer signal can be sampled in several ways to obtain the mean wind speed. Here we discuss the sampling of series of mean wind speeds from consecutive rotor rotations, followed by unweighted and weighted averaging. It is shown that the unweighted averaging creates a positive bias on the long-term mean wind speed, which is at least one order of magnitude larger than the positive bias from the weighted averaging, also known as the sample-and-hold method. For a homogeneous, neutrally stratified flow the first biases are 1%-2%. For comparison the biases due to fluctuations of the three wind velocity components and due to calibration non-linearity are determined under the same conditions. The largest of these is the v-bias from direction fluctuations. The calculations pertain to the Risø P2546A model cup anemometer.

  4. Reasoning about RoboCup Soccer Narratives

    Hajishirzi, Hannaneh; Mueller, Erik T; Amir, Eyal


    This paper presents an approach for learning to translate simple narratives, i.e., texts (sequences of sentences) describing dynamic systems, into coherent sequences of events without the need for labeled training data. Our approach incorporates domain knowledge in the form of preconditions and effects of events, and we show that it outperforms state-of-the-art supervised learning systems on the task of reconstructing RoboCup soccer games from their commentaries.

  5. The Economic Impact of the World Cup

    Stefan Szymanski


    The World Cup will be the biggest sporting event of 2002, but the Japanese and Korean governments are also hoping that it will be one of the biggest economic events of the year. Impact studies by respected economic research institutes predict a dramatic boost to GDP in both countries. This paper explains how these forecasts are generated and explains the tendency for such forecasts to be over-optimistic. The paper concludes with some policy recommendations for governments and sporting bodies ...

  6. [Progress of researches on the mechanism of cupping therapy].

    Cui, Shuai; Cui, Jin


    Cupping therapy of Chinese medicine is able to relieve a variety of diseases or clinical conditions, which results from the comprehensive effects of multiple types of stimulation exerted onto the regional acupoint areas. Among the stimuli, the negative pressure from cupping is one of the main factors inducing therapeutic effects. In the present paper, the authors review development of researches on the underlying mechanism of therapeutic effects of cupping-negative pressure from 1) the factor of intra-cup negative pressure; 2) influence of intra-cup negative pressure on cup-blackspot formation; 3) influence of cupping on regional blood vessels and blood flow; 4) effect of cupping on regional ultrastructure of the capillary in the raw-surface tissue; 5) effect of cupping-negative pressure on regional endothelial cells; and 6) biological effects of negative pressure drainage. Generally, cupping induced negative pressure can dilate local blood vessels to improve microcirculation, promote capillary endothelial cells repair, accelerate granulation and angiogenesis, etc., in the regional tissues, normalizing the patients' functional state at last.

  7. Management of knee osteoarthritis with cupping therapy.

    Khan, Asim Ali; Jahangir, Umar; Urooj, Shaista


    The study aimed to evaluate the effect of cupping therapy at a clinical setting for knee osteoarthritis. A randomized, controlled clinical trial was conducted. Cupping was performed on 0-6(th) day; 9-11(th) day and 14(th) day, i.e., 11 sittings follow-up to determine longer term carryover of treatment effects utilizing both objective and subjective assessment. The assessment was performed before and after treatment spreading over a period of 15 days. The results of this study shows significant and better results in the overall management of knee osteoarthritis, particularly in relieving pain, edema, stiffness and disability. The efficacy of treatment with cupping therapy in relieving signs and symptoms of knee osteoarthritis is comparable to that of acetaminophen 650 mg thrice a day orally, in terms of analgesia, anti-inflammatory and resolution of edema with minimal and temporary side-effects like echymosis and blister formation while as control drug has greater side-effects particularly on upper gastrointestinal tract. It is recommended that further studies are conducted with a larger study samples and of longer duration.

  8. Management of knee osteoarthritis with cupping therapy

    Asim Ali Khan


    Full Text Available The study aimed to evaluate the effect of cupping therapy at a clinical setting for knee osteoarthritis. A randomized, controlled clinical trial was conducted. Cupping was performed on 0-6 th day; 9-11 th day and 14 th day, i.e., 11 sittings follow-up to determine longer term carryover of treatment effects utilizing both objective and subjective assessment. The assessment was performed before and after treatment spreading over a period of 15 days. The results of this study shows significant and better results in the overall management of knee osteoarthritis, particularly in relieving pain, edema, stiffness and disability. The efficacy of treatment with cupping therapy in relieving signs and symptoms of knee osteoarthritis is comparable to that of acetaminophen 650 mg thrice a day orally, in terms of analgesia, anti-inflammatory and resolution of edema with minimal and temporary side-effects like echymosis and blister formation while as control drug has greater side-effects particularly on upper gastrointestinal tract. It is recommended that further studies are conducted with a larger study samples and of longer duration.

  9. Compilation of LLNL CUP-2 Data

    Eppich, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kips, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lindvall, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    The CUP-2 uranium ore concentrate (UOC) standard reference material, a powder, was produced at the Blind River uranium refinery of Eldorado Resources Ltd. in Canada in 1986. This material was produced as part of a joint effort by the Canadian Certified Reference Materials Project and the Canadian Uranium Producers Metallurgical Committee to develop a certified reference material for uranium concentration and the concentration of several impurity constituents. This standard was developed to satisfy the requirements of the UOC mining and milling industry, and was characterized with this purpose in mind. To produce CUP-2, approximately 25 kg of UOC derived from the Blind River uranium refinery was blended, homogenized, and assessed for homogeneity by X-ray fluorescence (XRF) analysis. The homogenized material was then packaged into bottles, containing 50 g of material each, and distributed for analysis to laboratories in 1986. The CUP-2 UOC standard was characterized by an interlaboratory analysis program involving eight member laboratories, six commercial laboratories, and three additional volunteer laboratories. Each laboratory provided five replicate results on up to 17 analytes, including total uranium concentration, and moisture content. The selection of analytical technique was left to each participating laboratory. Uranium was reported on an “as-received” basis; all other analytes (besides moisture content) were reported on a “dry-weight” basis.

  10. Acetabular anteversion is associated with gluteal tendinopathy at MRI

    Moulton, Kyle M. [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada); Royal University Hospital, Department of Medical Imaging, Saskatoon, SK (Canada); Aly, Abdel-Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Rajasekaran, Sathish [Health Pointe - Pain, Spine and Sport Medicine, Edmonton, AB (Canada); Shepel, Michael; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)


    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4 , 95 % confidence interval (CI): 17.2 -19.6 ] compared with normal controls (mean: 15.7 , 95 % CI: 14.7 -16.8 ). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8 , 95 % CI: 16.2 -21.6 ). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition. (orig.)

  11. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai


    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  12. Compilation of LLNL CUP-2 Data

    Eppich, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kips, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lindvall, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    The CUP-2 uranium ore concentrate (UOC) standard reference material, a powder, was produced at the Blind River uranium refinery of Eldorado Resources Ltd. in Canada in 1986. This material was produced as part of a joint effort by the Canadian Certified Reference Materials Project and the Canadian Uranium Producers Metallurgical Committee to develop a certified reference material for uranium concentration and the concentration of several impurity constituents. This standard was developed to satisfy the requirements of the UOC mining and milling industry, and was characterized with this purpose in mind. To produce CUP-2, approximately 25 kg of UOC derived from the Blind River uranium refinery was blended, homogenized, and assessed for homogeneity by X-ray fluorescence (XRF) analysis. The homogenized material was then packaged into bottles, containing 50 g of material each, and distributed for analysis to laboratories in 1986. The CUP-2 UOC standard was characterized by an interlaboratory analysis program involving eight member laboratories, six commercial laboratories, and three additional volunteer laboratories. Each laboratory provided five replicate results on up to 17 analytes, including total uranium concentration, and moisture content. The selection of analytical technique was left to each participating laboratory. Uranium was reported on an “as-received” basis; all other analytes (besides moisture content) were reported on a “dry-weight” basis. A bottle of 25g of CUP-2 UOC standard as described above was purchased by LLNL and characterized by the LLNL Nuclear Forensics Group. Non-destructive and destructive analytical techniques were applied to the UOC sample. Information obtained from short-term techniques such as photography, gamma spectrometry, and scanning electron microscopy were used to guide the performance of longer-term techniques such as ICP-MS. Some techniques, such as XRF and ICP-MS, provided complementary types of data. The results

  13. Analytic methods in assessment of optic nerve cupping.

    Jindra, L F; Kuběna, T; Gaudino, R N


    The intent of this paper is to provide a systems-based analysis of the methods used to evaluate optic nerve cupping, identify potential flaws in these systems, and propose alternatives better to assess this anatomic quantity. Estimation of optic nerve cupping requires an analytic understanding of both the psychophysical as well as the mathematical bases inherent in this measure. When the (decimal-based) cup-to-disc ratio is used to quantitate optic nerve cupping, a one-dimensional, linear estimate is produced, which in turn is derived from two- or three-dimensional, non-linear physical quantities of area or volume, respectively. When extrapolating from volume, to area, to linear measures, due to the psychophysical constraints which limit this task, such a data-compressed estimate of optic nerve cupping may neither accurately reflect, nor correctly represent, the true amount of cupping actually present in the optic nerve head. This type of one-dimensional metric (when comparing calculations from two- or three-dimensional measures over a range of optic nerve cupping), appears to introduce errors which, while most pronounced earlier on in the disease progression, often overestimate the amount of relative cupping (percent cupping) present in a pathological process like glaucoma. The same systemic errors can also lead to overestimation of the progression in cupping, especially in optic nerves with low cup-to disc values. To provide clinically meaningful estimates of optic nerve cupping, the practitioner needs to be aware of psychophysical and mathematical limitations inherent in using a linear cup-to-disc ratio to estimate the amount of cupping observed in a physical structure like the optic disc. The resultant flaws introduced by observer extrapolation from three, to two, to one dimensions (volume, area, and linear); transposition from non-linear to linear quantities; and optical illusions, caused by factors like disc topology, morphology, and ametropia, can all

  14. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

    G. García del Pino


    Full Text Available En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes casos de carga simulando pacientes con diferente peso corporal y actividades físicas. Paraevaluar los resultados se crearon rutinas en lenguaje C que organizaron los mismos para un tratamiento estadísticoposterior.Palabras claves: biomecánica, ortopedia, elementos finitos, modelación, desgaste, prótesis de cadera.___________________________________________________________________________Abstract.A wear study of acetabular component during the marching cycle, considering some extreme loads cases as: ascend anddescend stairways, get up from a seat, etc , by means of Finite Elements Method ( FEM , is carried out. The acetabular andfemoral component of the total hip prosthesis were independently modeled and placed in contact lastly. Several acetabulpositions were studied as well as different load cases, simulating patients with different body weight and different physicalactivities. To evaluate the results routines in C language were created in order to organized the same ones for a laterstatistical treatment.Key words. biomechanics, ortophedy, finite elements, modelation, wear, hip bone prosthesis.

  15. Dysplasia in Inflammatory Bowel Diseases: Definition and Clinical Impact

    Karel Geboes


    Full Text Available Dysplasia is a morphological term that ethymologically means ‘malformation’. For the definition of inflammatory bowel disease-related dysplasia, the nature and origin of the malformation are stressed and the lesion is defined as an epithelial malformation that is unequivocally neoplastic but noninvasive. The use of a precise definition is necessary because of the clinical consequences related to the finding of dysplasia in IBD. The microscopic diagnosis of dysplasia, however, remains difficult. Clinically, it is important to make a proper differential diagnosis between polypoid IBD-related dysplasia and sporadic adenoma occurring in IBD, and between therapy-related ‘pseudodysplasia’ and genuine dysplasia. When dysplasia is diagnosed, a second opinion may be indicated because of the clinical consequences. Additional techniques to search for genetic defects associated with carcinogenesis can help to support the diagnosis. They can identify changes in DNA content and molecular changes resulting from defects of genes controlling cell proliferation and death or tissue structure. These changes can, however, be absent, appear early or late in the transition from normality toward dysplasia and cancer, or appear during repair. Positive findings indicate an increased cancer risk, but the magnitude of the risk remains to be defined. A positive diagnosis of genuine dysplasia necessitates clinical action – either follow-up of the patient or treatment. In practice, treatment means surgery because dysplasia can be a precursor and/or a marker of malignancy, except for sporadic adenomas, which can be removed locally.

  16. Free iliac crest grafts with periosteum for treatment of old acetabular defects

    ZHAO De-wei; SUN Qiang; WANG Ben-jie; CUI Da-ping


    Objective: To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects.Methods: From February 1996 to June 2005, 9 patients were treated with free iliac crest grafts with periosteum to reconstruct old acetabular defects. There were 7 males and 2 females and the average age was 41.3 years. The acetabular defects were caused by traffic accidents in 6 cases and fall injury in 3 cases. The time from injury to treatment was 4-13 months and averaged 8 months. Intraoperatively we firstly removed the acetabular fracture fragments of the posterior wall. The femoral head was then reducted. Bone graft was harvested from the iliac crest with periosteum, which was sculpted with a rongeur to conform to the defect. The concave (iliac fossa) side of the graft was placed toward the femoral head. The graft was securedly fixed by two to three leg screws.Results: Postoperative syndrome was not found in any of the cases. Harris' score system showed that the score raised from 32. 3 points preoperatively to 81 points postoperatively. The hip function was evaluated as excellent in 3 cases, good in 4 cases and fair in 2 cases.Conclusions: Although this procedure could not exactly reproduce the anatomy of the hip joint, it enables to restore the posterior stability, provide bone-stock for the hip joints and prevent dislocation of the femoral head.

  17. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;


    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  18. Acetabular allograft reconstruction in total hip arthroplasty. Part I: Current concepts in biomechanics.

    Stiehl, J B


    Allograft reconstruction has become an essential tool for restoration of acetabular bone stock lost in failed total hip arthroplasty or resected in tumor reconstruction. This first segment of a two-part review will discuss the current status of allograft applications, together with pertinent biologic and biochemical aspects. Part II will address surgical considerations and recent clinical experience.

  19. Wear numbers for ball cup and journal bearings

    Ligterink, D.J.; Moes, H.


    A wear number is defined for ball cup bearings and for journal bearings where the cup and the cylindrical bearing are made of soft material. This dimensionless wear number provides a relation between the following five quantities: the radius of the ball or the length of the journal bearing in millimetres, the wear modulus in newtons per square millimetre, the maximum wear depth rate of the cup or the cylindrical bearing in millimetres per second, the force between the mating surfaces in newto...

  20. Optimization of the blank holder force in cup drawing

    Gharib, H.; A.S. Wifi,; M. Younan; Nassef, A


    Purpose: Develop an optimization strategy for the cup drawing process in order to produce a defect free deepdrawn cup.Design/methodology/approach: An optimization strategy for the blank holder force (BHF) scheme is proposedwhich searches for the BHF scheme that minimizes the maximum punch force and avoids process limits. Thisstrategy is applied to the linearly varying BHF scheme and compared to the constant BHF.Findings: The optimized linear BHF scheme resulted in an improved cup forming when...

  1. Perceptual elements in Penn & Teller's "Cups and Balls" magic trick.

    Rieiro, Hector; Martinez-Conde, Susana; Macknik, Stephen L


    Magic illusions provide the perceptual and cognitive scientist with a toolbox of experimental manipulations and testable hypotheses about the building blocks of conscious experience. Here we studied several sleight-of-hand manipulations in the performance of the classic "Cups and Balls" magic trick (where balls appear and disappear inside upside-down opaque cups). We examined a version inspired by the entertainment duo Penn & Teller, conducted with three opaque and subsequently with three transparent cups. Magician Teller used his right hand to load (i.e. introduce surreptitiously) a small ball inside each of two upside-down cups, one at a time, while using his left hand to remove a different ball from the upside-down bottom of the cup. The sleight at the third cup involved one of six manipulations: (a) standard maneuver, (b) standard maneuver without a third ball, (c) ball placed on the table, (d) ball lifted, (e) ball dropped to the floor, and (f) ball stuck to the cup. Seven subjects watched the videos of the performances while reporting, via button press, whenever balls were removed from the cups/table (button "1") or placed inside the cups/on the table (button "2"). Subjects' perception was more accurate with transparent than with opaque cups. Perceptual performance was worse for the conditions where the ball was placed on the table, or stuck to the cup, than for the standard maneuver. The condition in which the ball was lifted displaced the subjects' gaze position the most, whereas the condition in which there was no ball caused the smallest gaze displacement. Training improved the subjects' perceptual performance. Occlusion of the magician's face did not affect the subjects' perception, suggesting that gaze misdirection does not play a strong role in the Cups and Balls illusion. Our results have implications for how to optimize the performance of this classic magic trick, and for the types of hand and object motion that maximize magic misdirection.

  2. Aerodynamic Analysis of Cup Anemometers Performance: The Stationary Harmonic Response

    Santiago Pindado; Javier Cubas; Ángel Sanz-Andrés


    The effect of cup anemometer shape parameters, such as the cups’ shape, their size, and their center rotation radius, was experimentally analyzed. This analysis was based on both the calibration constants of the transfer function and the most important harmonic term of the rotor’s movement, which due to the cup anemometer design is the third one. This harmonic analysis represents a new approach to study cup anemometer performances. The results clearly showed a good correlation between the ave...

  3. Aerodynamic analysis of cup anemometers performance: the stationary harmonic response.

    Pindado, Santiago; Cubas, Javier; Sanz-Andrés, Angel


    The effect of cup anemometer shape parameters, such as the cups' shape, their size, and their center rotation radius, was experimentally analyzed. This analysis was based on both the calibration constants of the transfer function and the most important harmonic term of the rotor's movement, which due to the cup anemometer design is the third one. This harmonic analysis represents a new approach to study cup anemometer performances. The results clearly showed a good correlation between the average rotational speed of the anemometer's rotor and the mentioned third harmonic term of its movement.

  4. [The manipulation technique and clinical application of kinetic cupping].

    Luo, Rong; Liu, Qi; Sun, Dan


    The characteristic of kinetic cupping is explained from treatment principles, manipulation and clinical application. The kinetic cupping is a new particular therapy that combines traditional cupping and kinetic therapy. With cups on the patient, limb action like flexion-extension, adduction-abduction and rotation is made to reinforce clinical effects, which has simple and safe manipulation, obvious efficacy and is well accepted by patient. It has more obvious advantage for pain that was caused by large-area soft tissue injury and discomfort where acupuncture is not appropriate.

  5. Prosthodontic management of anhidrotic ectodermal dysplasia

    Shilpy Gupta


    Full Text Available Ectodermal dysplasia is characterized by the absence or defects of two or more ectodermally derived structures. Anodontia or hypodontia is the most striking dental manifestation. In severe hypodontia, there is lack of alveolar development with consequent protrusion and eversion of the lips. Patients with anhidrotic forms suffer from heat intolerance due to lack of sweat glands and mild infections may lead to death in infancy from hyperthermia. A case of a 4-year-old child with anhidrotic ectodermal dysplasia with partial anodontia is presented. Dental, oral, and physical features were taken into consideration in diagnosis and treatment planning for this patient. Clinical management consisted of removable partial prosthesis in maxillary arch and complete denture prosthesis in mandibular arch. The main aim of the treatment was to improve psychological development and to promote better functioning of the stomatognathic system.

  6. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao


    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  7. Atypical parakeratosis: a marker of dysplasia?

    Voytek, T M; Kannan, V; Kline, T S


    The Bethesda System categorizes atypical parakeratosis (APK) as "ASCUS or SIL depending on the degree of cellular abnormalities." APK, however, is not well-defined. We retrospectively reviewed 68 cervicovaginal specimens with follow-up material to identify specific criteria and clinical significance of APK. APK cells were small cells, 2-3 times the diameter of neutrophil, with dense, orangeophilic cytoplasm, high nuclear cytoplasmic ratio, dense, often uneven chromatin, and irregular nuclear contour. Of 62 cases with APK, 37 had accompanying dysplastic cells. Of 25 cases with APK alone, follow-up revealed 12 with squamous intraepithelial lesion (5 HSIL and 7 LSIL) and 13 with benign changes. A major diagnostic pitfall of APK was inflammation with degeneration. Abundant APK cells, minimal inflammation and degeneration, and previous history of dysplasia frequently were associated with follow-up SIL. The findings of this study identify APK as an important marker for dysplasia that warrants careful evaluation and follow-up.

  8. Arrhythmogenic right ventricular dysplasia: A case report

    Tessa Negrín Valdés


    Full Text Available Arrhythmogenic right ventricular dysplasia is a heart muscle disease that predominantly affects the right ventricle, bringing about the replacement of normal myocardium with fatty or fibrofatty tissue and causing sudden death in young individuals. Ventricular tachycardia is an important clinical manifestation, although there are reports of right or global heart failure. The diagnosis is confirmed by echocardiography and magnetic resonance imaging. The case of a 65-year-old former smoker, with hypertension and ischemic heart disease, a history of effort syncope symptoms and proven non-sustained ventricular tachycardia, with morphology of left bundle branch block, is reported. Relevant diagnostic studies were performed, and echocardiographic elements which were compatible with arrhythmogenic right ventricular dysplasia were found. Therefore, an implantable cardioverter defibrillator was implanted, after which the patient has had a favorable outcome.

  9. Distinctive skeletal dysplasia in Cockayne syndrome

    Silengo, M.C.; Franceschini, P.; Bianco, R.; Biagioli, M.; Pastorin, L.; Vista, N.; Baldassar, A.; Benso, L.


    Cockayne syndrome is a well-known autosomal recessive form of dwarfism with senile-like appearance. Skeletal changes such as flattening of vertebral bodies, ivory epiphyses and thickening of cranial vault, have been observed in some patients with this condition. We describe here a 5.5-year-old girl with the typical clinical signs of Cockayne syndrome and a distinctive form of bone dysplasia with major involvement of the spine.

  10. MR imaging features of craniodiaphyseal dysplasia

    Marden, Franklin A. [Mallinckrodt Institute of Radiology, Washington University Medical Center, 510 South Kingshighway Blvd., MO 63110, St. Louis (United States); Department of Radiology, St. Louis Children' s Hospital, Children' s Place, MO 63110, St. Louis (United States); Wippold, Franz J. [Mallinckrodt Institute of Radiology, Washington University Medical Center, 510 South Kingshighway Blvd., MO 63110, St. Louis (United States); Department of Radiology, St. Louis Children' s Hospital, Children' s Place, MO 63110, St. Louis (United States); Department of Radiology/Nuclear Medicine, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, MD 20814, Bethesda (United States)


    We report the magnetic resonance (MR) imaging findings in a 4-year-old girl with characteristic radiographic and computed tomography (CT) features of craniodiaphyseal dysplasia. MR imaging exquisitely depicted cranial nerve compression, small foramen magnum, hydrocephalus, and other intracranial complications of this syndrome. A syrinx of the cervical spinal cord was demonstrated. We suggest that MR imaging become a routine component of the evaluation of these patients. (orig.)

  11. Monostotic fibrous dysplasia with Raynaud's phenomenon.

    Kumar, K V S Hari; Aravinda, K; Narayanan, K


    Fibrous dysplasia (FD) is a benign bone disorder characterized by alteration in bone morphology. Monostotic FD is the commonest variant and affects the craniofacial bones. Raynaud's phenomenon is recurrent vasospasm of the fingers and toes due to cold exposure. The disease is usually idiopathic or secondary to connective tissue disorders. Raynaud's phenomenon is not described previously with FD. We recently encountered two interesting patients of craniofacial monostotic FD with Raynaud's phenomenon and report the same in this report.

  12. A Case Report of Camptomelic Dysplasia

    Zia Islami


    Full Text Available Camptomelic Dysplasia (CMD is a rare autosomal dominant congenital dwarfism characterized by shortness and bowing of long bones (camptomelia and other severe skeletal and extra skeletal malformations. CMD is generally considered to be lethal and the majority of cases die in the neonatal period due to respiratory insufficiency.We hereunder report a term male neonate with characteristic clinical and radiological findings of CMD, hydrocephaly, no sex reversal, and a negative family history of skeletal problems who was born to non-consanguineous  healthy parents and was admitted to Shahid Sadoughi Hospital, Yazd, Iran,immediately after birth due to respiratory distress.The patient required continuous mechanical ventilation support and all attempts to reduce respiratory support failed and the patient died on the 21th day of his life. Camptomelic Dysplasia is a terrible experience for parents; thus, prenatal diagnosis of CMD by ultrasound is essential and mandatory for a better therapeutic intervention.Key words: Camptomelic dysplasia; dwarfism/congenital; bowing of longbones; sex-reversal

  13. Malignant transformation of fibrous dysplasia into chondroblastic osteosarcoma

    Kaushik, Shaifali [Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA (United States); Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA (United States); Smoker, Wendy R.K. [Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA (United States); Frable, William J. [Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA (United States)


    A case of malignant transformation of polyostotic fibrous dysplasia into maxillary chondroblastic osteosarcoma is presented. The clinical, radiographic, CT, MR imaging features and pathological findings of polyostotic fibrous dysplasia and its malignant transformation are described. Malignant transformation of fibrous dysplasia is rare and has not previously been described in the English literature in this location in McCune-Albright syndrome and in the absence of radiation treatment. (orig.)

  14. Thanatophoric Dysplasia; a Rare Case Report on a Congenital Anomaly

    Maria Francis Yuvaraj


    Full Text Available The rare form of skeletal dysplasia is thanatophoric dysplasia. The meaning for thanatophoric dysplasia is death bearing which is derived from Greek word. It occurs 1in 20,000 to 50,000. It is mainly due to mutations in the fibroblast growth factor receptor 3gene. Features of thanatophoric dysplasia are frontal bossing, prominent eyes, narrow thorax, protruded abdomen and bowed legs. The knowledge about this condition is useful in the fields of Anatomy, Paediatrics, Obstetrics and Gynaecology, Ultrasonagraphy and Genetics, for future research purpose.

  15. The Ectodermal Dysplasias : Severe Palmoplantar Hyperkeratosis And Chronic Angular Cheilitis

    Mahajan Vikram K


    Full Text Available The ectodermal dysplasias are congenital, non-progressive and diffuse disorders affecting primarily the tissues derived from ectoderm. Over a period, their classification has become confusing due to indiscriminate use of them “ectodermal dysplasia” for numerous syndromes with a defect in one or more epidermal defect in each element of skin; their precise classification appears difficult as yet. Only X-linked recessive ectodermal dysplasia (Christ-Siemens-Touraine syndrome remains best defined. This paper describes three cases of ectodermal dysplasias highlighting their overlapping features.

  16. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik


    Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation....... Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0...

  17. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten


    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction.

  18. Experimental study on treatment of acetabular anterior column fractures: applyment of a minimally invasive percutaneous lag screw guide apparatus

    Zhang, Li-hai; Zhang, Li-cheng; Si, Qing-hua; Gao, Yuan; Su, Xiu-Yun; Zhao, Zhe; Tang, Pei-Fu


    Background The aim of this study was to design a new minimally invasive percutaneous lag screw guide apparatus and to verify its adjuvant treatment of acetabular anterior column fracture on pelvis specimens. Methods This guide apparatus was self-developed based on the principles of “two points form a line” and “Rectangle”. Using C-arm fluoroscopy, this guide apparatus was used to conduct minimally invasive percutaneous lag screw internal fixation of acetabular anterior column fractures. Ten h...

  19. Development of an Innovative Medical Cupping Device

    Feng-Chyi Duh


    Full Text Available Temperature increases to influence the organs are often used in Chinese medicine therapy. A heat therapy cup was developed in this study with temperature control, timer, and heat therapy functions. The concept behind these therapeutic aids is traditional Chinese medicine combined with modern technology and the designs include timers and temperature control. The completed prototypes were used for cupping therapy. After testing, it was found that the standard deviation was greater at a lower temperature setting (To while at a higher To the standard deviation was lower. At To of 30, 40, 50, and 60°C, the relative changes in standard deviations were 5.27%, 2.50%, 2.66%, and 0.88%, respectively. The results indicated that the timer and temperature control functioned properly. Therefore, the designed medical aid, which is an important tool in Chinese medicine, can be provided to people of all ages to maintain health, help with rehabilitation, or to boost energy.

  20. Flow distortion on boom mounted cup anemometers

    Lindeloew-Marsden, P.; Pedersen, Troels F.; Gottschall, J.; Vesth, A.; Paulsen, R.W.U.; Courtney, M.S.


    In this report we investigate on wind direction dependent errors in the measurement of the horizontal wind speed by boom mounted cup anemometers. The boom mounting on the studied lattice tower is performed according to IEC standard design rules, yet, larger deviations than predicted by flow models are observed. The errors on the measurements are likely caused by an underestimation of the flow distortions around the tower. In this paper an experimental method for deriving a correction formula and an in-field calibration is suggested. The method is based on measurements with two cup anemometers mounted with booms at the same height but pointing in 60 deg. different directions. In the examined case of a 1.9 m wide equilateral triangular lattice tower with booms protruding 4.1 m at 80 m height the measurement errors are observed to reach up to +- 2 %. Errors of this magnitude are severely problematic in the measurement of wind turbine power performance, wind resource assessment and for providing purposeful in-field comparisons between different sensors, e.g. lidar anemometers. With the proposed method, direction dependent errors can be extracted and the mast flow distortion effect on the wind measurements corrected to an uncertainty estimated to better than 0.5%. This level of uncertainty is probably acceptable for the above mentioned applications. (author)


    Awad D.S


    Full Text Available Deep drawing is a process for shaping flat sheets into cup shaped articles without fracture or excessive localized thinning. The complex deep drawing of thin metallic sheets is widely used during industrial material forming applications. It allows production of thin walled parts with complicated shapes such as automotive panels or structural parts. The process consists of the plastic deformation of an initial at blank subjected to the action of a rigid punch and die while constrained on the periphery by a blank holder. Conventional design processes for sheet metal forming are usually based on a empirical approach. However, due to the requirement of high precision and reliability in shaped parts, these methods are far away from a final and reliable solution. Nowadays, Finite Element Method (FEM is being gradually adopted by industry to envisage the formability properties of sheet metals. The design and control of a deep drawing process depends not only on the work piece material, but also on the condition at the tool work piece interface, the mechanics of plastic deformation and the equipment used. In this paper, rectangular cup component of EDDQ Steel and Mild Steel is simulated using HYPERMESH 11 by varying various process parameters.

  2. Prevalence of disc cupping in non-glaucomatous eyes.

    Chiappe, José Pablo; Nahum, Pablo; Casiraghi, Javier F; Iribarren, Rafael


    This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter 1.5 times (respectively) the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

  3. Frictional torque numbers for ball cup and journal bearings

    Ligterink, D.J.


    Plastic bearing material wears in ball cup and journal bearings. Contact areas in the ball cup and the journal bearing increase. The frictional torque needed to rotate the ball or journal also increases. When the coefficient of friction is assumed to be constant during wearing out, the frictional t

  4. Frictional torque numbers for ball cup and journal bearings

    Ligterink, D.J.


    Plastic bearing material wears in ball cup and journal bearings. Contact areas in the ball cup and the journal bearing increase. The frictional torque needed to rotate the ball or journal also increases. When the coefficient of friction is assumed to be constant during wearing out, the frictional torque increases to a maximum of 1.273 times the frictional torque at zero wear.

  5. Wear numbers for ball cup and journal bearings

    Ligterink, D.J.; Moes, H.


    A wear number is defined for ball cup bearings and for journal bearings where the cup and the cylindrical bearing are made of soft material. This dimensionless wear number provides a relation between the following five quantities: the radius of the ball or the length of the journal bearing in millim

  6. A critical comparison of ten disposable cup LCAs

    Harst, Eugenie van der, E-mail: [Environmental Systems Analysis Group, Wageningen University, P.O. Box 47, NL-6700 AA Wageningen (Netherlands); Potting, José, E-mail: [Environmental Systems Analysis Group, Wageningen University, P.O. Box 47, NL-6700 AA Wageningen (Netherlands); Environmental Strategies Research (fms), KTH Royal Institute of Technology, SE-110 44 Stockholm (Sweden)


    Disposable cups can be made from conventional petro-plastics, bioplastics, or paperboard (coated with petro-plastics or bioplastics). This study compared ten life cycle assessment (LCA) studies of disposable cups with the aim to evaluate the robustness of their results. The selected studies have only one impact category in common, namely climate change with global warming potential (GWP) as its category indicator. Quantitative GWP results of the studies were closer examined. GWPs within and across each study show none of the cup materials to be consistently better than the others. Comparison of the absolute GWPs (after correction for the cup volume) also shows no consistent better or worse cup material. An evaluation of the methodological choices and the data sets used in the studies revealed their influence on the GWP. The differences in GWP can be attributed to a multitude of factors, i.e., cup material and weight, production processes, waste processes, allocation options, and data used. These factors basically represent different types of uncertainty. Sensitivity and scenario analyses provided only the influence of one factor at once. A systematic and simultaneous use of sensitivity and scenario analyses could, in a next research, result in more robust outcomes. -- Highlights: • Conflicting results from life cycle assessment (LCA) on disposable cups • GWP results of LCAs did not point to a best or worst cup material. • Differences in GWP results are due to methodological choices and data sets used. • Standardized LCA: transparency of LCA studies, but still different in approaches.

  7. Five Cups: Observation, Experimentation, and Communication in Science.

    Bauer, Christopher F.


    Describes the five-cups activity in which students explore materials in the cups. Discusses the effects of this activity on students' understanding of the nature of evidence and the quality and evaluation of that evidence. Includes test results during class and overnight. (KHR)

  8. Quantitative measures of damage to subchondral bone are associated with functional outcome following treatment of displaced acetabular fractures.

    Lubovsky, Omri; Kreder, Michael; Wright, David A; Kiss, Alex; Gallant, Aimee; Kreder, Hans J; Whyne, Cari M


    Current analysis of displaced acetabular fractures is limited in its ability to predict functional outcome. This study aimed to (1) quantify initial acetabular damage following acetabular fracture through measurement of subchondral bone density and fracture lines, and (2) evaluate associations between acetabular damage and functional outcomes following fracture. Subchondral bone intensity maps were created for 24 patients with unilateral acetabular fractures. Measures of crack length and density differences between corresponding regions in the fractured acetabuli, normalized by the unfractured side, were generated from preoperative CT images. Damage measures were compared to quality of life survey data collected for each patient at least 2 years post-injury (Musculoskeletal Functional Assessment [MFA] and Short Form-36 [SF-36], with specific focus on parameters that best describe patients' physical health). CT image quantification of initial damage to acetabular subchondral bone was associated with functional outcome post-injury. In general, damage as quantified through differences in density in the superior dome region (zones 8 and 12) and the central anterior region of the acetabulum (zone 3) were found to be the strongest significant predictors of functional outcome (adjusted R(2) = 0.3-0.45, p fractures toward improving clinical prognoses.

  9. Distance constant of the Risø cup anemometer

    Kristensen, L.; Frost Hansen, O.


    The theory for cup-anemometer dynamics is presented in some detail and two methods of obtaining the distance constant lo are discussed. The first method is based on wind tunnel measurements: with a constant wind speed the cup anemometer is released from alocked position of the rotor...... and the increasing rotation rate recorded. It is concluded that the rapid increase in rotation rate makes the method very inaccurate. The second method consists of an analysis of turbulent, atmospheric of wind speed asmeasured by the cup anemometer and a fast-responding sonic anemometer with a spatial eddy...... resolution which is significantly better than that which can be obtained by a cup anemometer. The ratio between the measured power spectra of the horizontal windspeed by the two instruments contains the necessary information for determining the response characteristics of the cup anemometer and thereby lo...

  10. Bilateral developmental dysplasia of the hip treated with open reduction and Salter osteotomy: analysis on the radiographic results

    Anastácio Kotzias Neto


    Full Text Available Objectives:To evaluate the radiographic results from patients with bilateral developmental dysplasia of the hip (DDH who underwent surgical treatment by means of open reduction and Salter osteotomy, with or without associated femoral shortening as described by Ombrédanne.Methods:This was a retrospective descriptive study in which 21 patients with bilateral DDH (42 hips were analyzed. They were treated at Hospital Infantil Joana de Gusmão (HIJG, with operations between August 1997 and October 2009. To evaluate the radiographic results, the acetabular index and the Wiberg center-edge angle were measured, and the Severin and Kalamchi–MacEwen classifications were used. Descriptive and parametric statistical analyses were used to evaluate the data.Results:We did not observe any statistically significant difference in analyzing the radio-graphic parameters, making comparisons regarding the side affected, the order of the procedures and whether femoral shortening was performed, although there was a significant difference between them from before to after the operation.Conclusion:Open reduction in association with iliac osteotomy as described by Salter presented significant improvements in the radiographic parameters analyzed, comparing the pre- and postoperative values. This improvement occurred independently of whether Ombrédanne femoral shortening was performed. The most prevalent complication in the study group was avascular necrosis of the femoral head.

  11. 髋臼发育不良的光弹性生物力学研究%Biomechanical analysis of acetabular dystplasia with photoelosticity

    范广宇; 朱悦


    Objective To study the mechanism of osteoarthritis followed by cetabular dysplasia from the aspect of biomechanics and provide theoretical foundation for rotational acetabular osteotomy.Methods Epoxy was used to make the models of hip and femur which included four models of different shalp angle,three models of different thickness of cartilage and three models of different femoral neck body angle.Two ionalphotoelastic method was used for biomechanical analysis.Results As the sharp angle increased,the summated force endured by hip increased and the biotic stress moved to the lateral side of acetabulum;The summated force didn′t chang precisely when half of the cartilage was defective;When the cartilage didn′t exist the biotic stress was 2.5 times of that in normal condition; As the femoral neck body angle increased the biotic stress and summated force increased too,while the position on which the biotic stress concentrated didn′t change.Conclusion Cetabular dysplasia may result in osteoadhritis due to biomechanical factors. Rotational acetabular osteotomy is an effective treatment to such disease.%目的 从生物力学角度探讨髋臼发育不良继发骨关节炎的发病机理,为髋臼旋转截骨术提供依据。方法 用环氧树脂制作骨盆、股骨模型,其中包括4个不同Sharp角、3个不同软骨厚度及3个不同颈干角模型,采用二维光弹性方法进行生物力学分析。结果 随着Sharp角的增大,髋关节的合力增大,生物应力向髋臼外侧缘移动;关节软骨缺损一半时,髋关节合力未见明显变化,当关节软骨不存在时,生物应力为正常时的2.5倍;随着颈干角的增大,生物应力集中的位置没有变化,但生物应力及合力随之增大。结论 髋臼发育不良因生物力学因素可继发骨关节炎,髋臼旋转截骨术是对其有效的治疗方法。

  12. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.


    En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes cas...

  13. Marfan syndrome with multiseptate pneumothorax and mandibular fibrous dysplasia

    Kate A


    Full Text Available We describe a rare case of pneumothorax due to Marfan syndrome associated with fibrous dysplasia of the mandible. Marfan syndrome and fibrous dysplasia were possibly due to a common etiological factor. The association between the two and other tumors described in literature related to Marfan syndrome is discussed.

  14. Cleidocranial dysplasia: Report of 4 cases and review

    Virender Gombra


    Full Text Available Patients with cleidocranial dysplasia commonly present with significant dental problems such as retention of multiple deciduous teeth, impaction or delay in eruption of permanent teeth and often, the presence of supernumerary teeth. We report 4 cases of 2 families presenting with cleidocranial dysplasia disorder with their clinical and radiological diagnosis and illustrating its pathogenesis and various treatment modalities, review of literatures.

  15. Dyssegmental dysplasia in siblings: Prenatal ultrasonic diagnosis

    Andersen, P.E. Jr.; Hauge, M.; Bang, J.


    Two cases of dyssegmental dysplasia (type Silverman-Handmaker) in siblings are presented. The first-born died at the age of 3 months and the second fetus was followed during pregnancy with ultrasound examinations. In the 20th week of gestation marked shortening of the extremities was found; a female infant showing the same radiologic bony malformations as the firstborn was born by cesarean section. These cases support the autosomal recessive inheritance and demonstrate the possibility of prenatal diagnosis in this type of micromelic dwarfism. (orig.)

  16. Tibia Vara due to Focal Fibrocartilaginous Dysplasia

    A Tavakoli


    Full Text Available We present a case of unilateral tibia vara associated with an area of focal fibrocartilaginous dysplasia in the medial aspect of the right proximal tibia. Such a case has not been described previously. The affected child was 8 months old. Deformity resolved without aggressive treatment. The pathogenesis of the focal lesion remains controversial. The most likely explanation is that the mesenchymal anlage of the tibial metaphysis has for unknown reasons, developed abnormality at the insertion of the pes anserinus. Keywords: Tibia Vara, Pes Anserinus

  17. Pelvic, acetabular and hip fractures: What the surgeon should expect from the radiologist.

    Molière, S; Dosch, J-C; Bierry, G


    Pelvic ring fractures when caused by trauma, either violent or in demineralized bone, generally consist of injuries in both the anterior (pubic symphysis and rami) and posterior (iliac wing, sacrum, sacroiliac joint) portions. Injury classifications are based on injury mechanism and pelvic stability, and are used to determine treatment. Acetabular fractures, associated or not to pelvic ring disruption, are classified on the basis of fracture line, into elementary fractures of the acetabular walls, columns and roof, and into complex fractures. Fractures of the proximal end of the femur occur often on demineralized bone following low-energy trauma. The fractures are categorized by anatomic location (neck, trochanter and subtrochanteric region) and degree of displacement. These variables determine the risk of osteonecrosis of the femoral head, which is the main complication of such fractures.

  18. Femoro-acetabular impingement and hip pain with conventionally normal x-rays.

    Baker, J F


    There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.

  19. Arthroscopic excision of acetabular osteoid osteoma in a 7-year-old patient.

    Aşık, Mehmet; Erşen, Ali; Polat, Gökhan; Bilgili, Fuat; Tunalı, Onur


    The purpose of this study was to present the case report of a 7-year-old patient who was treated with hip arthroscopy for an acetabular osteoid osteoma. A 7-year-old patient was referred to our clinic with hip pain. In the assessment of the patient, an acetabular osteoid osteoma was detected in his right hip; it was adjacent to his triradiate cartilage. An arthroscopic surgery was planned as an alternative to open safe hip dislocation. The osteoid osteoma was completely removed with hip arthroscopy. Postoperative CT scanning and histopathological analysis confirmed the diagnosis. Exposure of the acetabulum can be problematic in paediatric patients due to the potential risks of open safe dislocation. Hip arthroscopy can safely be used for benign hip lesions in paediatric patients. Level of evidence Case report, Level V.

  20. An Automated Size Recognition Technique for Acetabular Implant in Total Hip Replacement

    Shapi'i, Azrulhizam; Hasan, Mohammad Khatim; Kassim, Abdul Yazid Mohd; 10.5121/ijcsit.2011.3218


    Preoperative templating in Total Hip Replacement (THR) is a method to estimate the optimal size and position of the implant. Today, observational (manual) size recognition techniques are still used to find a suitable implant for the patient. Therefore, a digital and automated technique should be developed so that the implant size recognition process can be effectively implemented. For this purpose, we have introduced the new technique for acetabular implant size recognition in THR preoperative planning based on the diameter of acetabulum size. This technique enables the surgeon to recognise a digital acetabular implant size automatically. Ten randomly selected X-rays of unidentified patients were used to test the accuracy and utility of an automated implant size recognition technique. Based on the testing result, the new technique yielded very close results to those obtained by the observational method in nine studies (90%).




    Full Text Available To determine the role of computed tomography and 3D Reconstructions in classification of pelvic rim and acetabular fractures and assessing possible changes in fracture classification . We collected retrospective information in a period of 18 months in our institution , of patients with pelvic injuries considering --- demographic data , radiological examination performed and the moment when it was performed , fracture classification and management . In 12 cases ( 54% there were isolated pelvic rim fr actures and 7 cases of isolated acetabular fractures ( 32% and 3 cases ( 14% involving both . After the CT scan was obtained , the initial classification was changed in five cases ( 22 . 7% . Tridimensional CT based modeling is very helpful in the classificati on of pelvic fractures and is a complement of the plain X - ray .

  2. Corrosion on the acetabular liner taper from retrieved modular metal-on-metal total hip replacements.

    Gascoyne, Trevor C; Dyrkacz, Richard M; Turgeon, Thomas R; Burnell, Colin D; Wyss, Urs P; Brandt, Jan-M


    Eight retrieved metal-on-metal total hip replacements displayed corrosion damage along the cobalt-chromium alloy liner taper junction with the Ti alloy acetabular shell. Scanning electron microscopy indicated the primary mechanism of corrosion to be grain boundary and associated crevice corrosion, which was likely accelerated through mechanical micromotion and galvanic corrosion resulting from dissimilar alloys. Coordinate measurements revealed up to 4.3mm(3) of the cobalt-chromium alloy taper surface was removed due to corrosion, which is comparable to previous reports of corrosion damage on head-neck tapers. The acetabular liner-shell taper appears to be an additional source of metal corrosion products in modular total hip replacements. Patients with these prostheses should be closely monitored for signs of adverse reaction towards corrosion by-products.

  3. Renal dysplasia and MRI: a clinician's perspective

    Greenbaum, Larry A. [Emory University, Division of Pediatric Nephrology, Children' s Healthcare of Atlanta, Atlanta, GA (United States)


    Renal dysplasia is a common abnormality in children. The role of MRI in evaluating children with renal dysplasia is evolving. More information is clearly necessary before MRI replaces conventional imaging modalities. In order to appropriately use MRI, the radiologist must have an understanding of the clinical questions that are important in the management of children with renal dysplasia. This review provides background information on renal dysplasia for the pediatric radiologist. The focus is on unilateral disease, especially multicystic dysplastic kidneys, and bilateral dysplasia, which is the most common cause of kidney failure in children. The emphasis is on the important clinical issues, and the potential of MRI as a methodology for providing clinically useful information not otherwise available from other imaging modalities. (orig.)

  4. [Importance of hand films in skeletal dysplasia (author's transl)].

    Fendel, H


    The hand, as part of the skeleton, is generally involved in systemic skeletal dysplasia. However, the degree of abnormalities differs considerably in the various types of dysplasia. In some, abnormal appearance of the hand predominates, in other dysplasia films of the hand provide only little or no useful diagnostic information. At their first examination for growth disorders children often reveal bone dysplasia on roentgenograms of the hand. Therefore, evaluation of hand films should be done as thoroughly as possible. Morphologic and/or metric deviations of the hand may bring the first suspicion although they are not fully diagnostic. Systemic skeletal dysplasia should be diagnosed or excluded by additional adequate radiologic and other clinical examinations.

  5. Learning RoboCup-Keepaway with Kernels

    Jung, Tobias


    We apply kernel-based methods to solve the difficult reinforcement learning problem of 3vs2 keepaway in RoboCup simulated soccer. Key challenges in keepaway are the high-dimensionality of the state space (rendering conventional discretization-based function approximation like tilecoding infeasible), the stochasticity due to noise and multiple learning agents needing to cooperate (meaning that the exact dynamics of the environment are unknown) and real-time learning (meaning that an efficient online implementation is required). We employ the general framework of approximate policy iteration with least-squares-based policy evaluation. As underlying function approximator we consider the family of regularization networks with subset of regressors approximation. The core of our proposed solution is an efficient recursive implementation with automatic supervised selection of relevant basis functions. Simulation results indicate that the behavior learned through our approach clearly outperforms the best results obta...

  6. Long-term outcome of operative management of delayed acetabular fractures

    ZHU Shi-wen; SUN Xu; YANG Ming-hui; LI Yu-neng; ZHAO Chun-peng; WU Hong-hua; CAO Qi-yong


    Background Surgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma.The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.Methods The operative approaches,procedures,results,and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital.Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.Results Sixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years).Excellent functional results were observed in 10 hip joints,good results in 40,fair results in 11,and poor results in nine.The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head,a time beyond 42 days from injury to operative management,and dislocation of femoral head during the injury.Some of the problems,which were observed included postoperative infection in two hips,iatrogenic sciatic nerve injury in eight hips,traumatic arthritis in 15 hips,heterotopic ossification in 17 hips,and necrosis of the femoral head in six hips.Conclusion A careful selection of operative indications for delayed acetabular fractures in combination with a proper ooerative aPProach and appropriate reduction and fixation could guarantee relatively good results.

  7. Magnetic resonance imaging of para-acetabular insufficiency fractures in patients with malignancy

    Theodorou, S.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]|[Department of Clinical Radiology, University of Manchester, Manchester (United Kingdom); Theodorou, D.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]. E-mail:; Schweitzer, M.E. [Department of Radiology, New York University Hospital for Joint Diseases, NY (United States); Kakitsubata, Y. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)


    AIM: To describe the characteristic magnetic resonance imaging (MRI) findings of para-acetabular insufficiency fractures in patients with malignancy, and compare the MRI appearance of these fractures with that of metastatic bone disease. MATERIALS AND METHODS: MRI examinations were reviewed in 16 patients with a known malignant tumour and severe hip pain that raised the possibility of local recurrence or metastatic disease. Six patients had received pelvic irradiation, and three patients were receiving steroid medication. RESULTS: The total number of fractures detected was 21: a solitary fracture was present in 11 patients and five patients had bilateral para-acetabular fractures. Two patients had associated sacral insufficiency fractures, and one of them had stress fractures involving both acetabular columns. Conventional radiography allowed the diagnosis of 14 (67%) fractures; six (28%) radiographic examinations were negative; and one (5%) examination was equivocal for fracture. Available scintigraphic and computed tomography (CT) studies revealed typical findings of fracture. Using MRI, insufficiency fractures appeared as linear regions of low signal intensity on T1- and T2-weighted images. Marked marrow oedema was evident in all cases. Fractures characteristically were parallel to the superior acetabulum in a curvilinear fashion in 18 (86%) instances, and were oblique in three (14%) instances. The fractures demonstrated considerable enhancement after intravenous gadolinium administration. No associated soft tissue masses were documented. CONCLUSION: Para-acetabular insufficiency fractures are a cause of hip pain, which may mimic skeletal metastasis in the patient with malignancy and pelvic irradiation. Recognition of the characteristic MRI findings of these fractures can preclude misdiagnosis and unnecessary bone biopsy.


    R. M. Tikhilov


    Full Text Available The authors presented the experience of treatment of two patients with hip arthritis after acetabular fracture. Both patients were treated with total hip replacement. During the operation, to manage posterior-superior bone defects of the acetabulum, augments of trabecular metal were used. Pain and limitation of motions in hip were indications for operative treatment. After a year of follow up there was no pain in hip; also recovery of motion and improved quality of life were observed.

  9. Selection of allografts for impaction bone grafting for bone defect reconstruction on the acetabular side

    XU Zheng-jian; HE Rong-xin


    Objective To review the choices of allografts for bone defect reconstruction in acetabular revision surgery using the technique of impaction bone grafting.Data sources The data cited in this review were mainly obtained from articles listed in PubMed that were published from January 1993 to July 2009. The search terms were "impaction bone grafting", "particle size", "mechanical property"and "biological behavior".Study selection Articles relevant to the choices of allografts and their results for bone defect reconstruction on the acetabular side were selected.Results Different choices of allografts, including the particle size, process of irradiation or fat reduction, composition and particle grade, are made to improve the survival rate of a prosthesis in acetabular revision surgery. This review,which compares both mechanical and biological factors, summarizes the experimental and clinical results for different techniques.Conclusions Fresh frozen cancellous allografts with particle sizes ranging from 7 to 10 mm are a favorable choice for reconstruction of bone defects of American Academy of Orthopedic Surgeons (AAOS) types Ⅱ (cavitary defect) and Ⅲ(combined cavitary and segmental defect) on the acetabular side. A fat-reducing procedure with saline or solvent/detergent is controversial. Adding autologous marrow into irradiated allografts, which provides reliable mechanical stability and biological safety, may be a substitute for fresh frozen allografts. Cortical bone can be a supplementary material in cases of insufficiency of cancellous allografts. Cartilage should be excluded from the graft material. Further research is required to demonstrate the best particle grade, and randomized controlled trials in clinical practice are required to obtain more information about the selection of allografts.

  10. Application of uncemented Zweymüller hip prosthesis in adult patients with hip osteoarthritis secondary to developmental dysplasia

    XU Yong-sheng; WANG Yan; LU Long; WEI Bao-gang


    Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ‘high-riding' hip.It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty (THA) for coxarthrosis.The aim of this study was to evaluate efficiency and safety of THA using Zweymüller hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip (DDH) in adults.Methods From January 2000 to February 2008,35 patients (40 hips) with developmental dysplasia of the hip were included.Five were male and 30 were female,with ages ranging from 26 to 65 years and an average age of 45 years.According to Hartofilakidis classification,there were type Ⅰ in 5 hips,type Ⅱ in 20 hips,type Ⅲ in 15 hips.All the patients were performed the THA using the Zweymüller hip implant.The preoperative average Harris score was 44.The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients.The patients mainly suffered from pain and claudication.Clinical and radiological results were analyzed.The Harris score was used for outcome measurement.Results Thirty five patients (40 hips) were followed and the mean follow-up period was 46 months (ranged from 24 months to 96 months).The latest follow-up average Harris score was 88.9 (97.1% of good rate).All the patients were pain-free and there was no sign of infection,aseptic loosening and subsidence.Conclusions In summary,THA using Zweymüller hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults.The key techniques for the total hip replacement are as follows:good preoperative plan,firmly placing the acetabular component in the true acetabulum,proper preparation of proximal femur,suitable femoral component choosing and improving the techniques of the bone graft.

  11. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Yasuhiro Homma


    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  12. An extremely rare case: osteosclerotic metaphyseal dysplasia.

    Kasapkara, C S; Küçükçongar, A; Boyunağa, O; Bedir, T; Oncü, F; Hasanoğlu, A; Tümer, L


    OMD (osteosclerotic metaphyseal dysplasia) is a very rare sclerosing bone disorder, first described by G. Nishimura in two Japanese siblings in 1993 (6). We report the case of a 12-month-old male with hypotonia, developmental delay and sclerosis of the metaphyses and epiphyses of specific bones. This 36-week gestation boy was born to a 26 year old gravida 5 para 1 Turkish mother and a 27 year old nonconsanguineous father. Radiographic findings obtained during the hospital stay included bilateral symmetrical osteosclerosis of the metaphyseal portions of the long bones in the upper and lower extremities with osteopenic shafts. Narrow bands of metaphyseal osteosclerosis were detected in the short tubular bones of the hands and feet. Growing parts of bilateral scapula, iliac, pubic and ischial bones show sclerotic bands. In addition superior and inferior plates of vertebras, transverse processes of sacral vertebras, all visible epiphyses, carpal and tarsal bones also show sclerotic changes. The scalp was unaffected. Based on the clinical, radiographic, and laboratory findings, a diagnosis of OMD was made. We do not know any of the osteosclerotic bone disorder with changes including hypotonia, mental and motor developmental delay and metaphyseal sclerosis of the bones with a unique distribution except OMD. The syndrome is characterized by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase, and late-onset spastic paraplegia 18 years ago. Our patient is the 4th case of OMD described in the literature share some clinical and radiological similarities with other three reported cases of osteosclerotic metaphyseal dysplasias.

  13. A Case of Extensive polyostotic fibrous dysplasia

    Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyunghee University, Seoul (Korea, Republic of)


    Fibrous dysplasia is a benign disorder of bone consisting of intramedullary proliferation of fibrous tissue and irregularly distributed, poorly developed bone. The disease manifests itself in the monostotic form in which only one bone is involved and the polyostotic form in which multiple bones at different sites are affected. We reported a extensive case of polyostotic fibrous dysplasia with involvement of craniofacial bones, mandible, ribs, extremities. A 18-year-old man showed remarkable right facial swelling who had been treated on right femur 3 years ago with a bone graft for pathologic fracture and he recognized facial swelling 5 years ago. Extraoral radiograms and computed tomogram showed diffuse sclerosis with a ground glass appearance of the most calvarial bones, facial bones. The right mandibular lesion showed very expansible lesion with mottled appearance. Bone scans showed multifocal increased uptakes in craniofacial bones, right mandible, bilaterally in ribs, humerus, femur, tibia and characteristic various deformity of right femur (shepherd's crook deformity). This case showed exceptionally bilateral, extensive nature of bone lesion and didn't show any features of skin pigmentation and endocrine disturbances.

  14. A Case of Placental Mesenchymal Dysplasia

    Shigeki Taga


    Full Text Available Placental mesenchymal dysplasia (PMD rarely complicates with pregnancy. A 30-year-old woman, gravida 3, para 3, presenting with placentomegaly, was referred to our department at 18 weeks of gestation. An ultrasonography revealed a normal fetus with a large multicystic placenta, measuring 125 × 42 × 80 mm. The border between the lesion and normal region was not clear. Color doppler revealed little blood flow in the lesion. Magnetic resonance imaging revealed normal fetus and a large multicystic placenta. Serum human chorionic gonadotropin level was 20124.97 U/L, which was normal at 20 weeks of gestation. Thus, placental mesenchymal dysplasia rather than hydatidiform mole with coexistent fetus was suspected. Then, routine checkup was continued. Because she had the history of Cesarean section, an elective Cesarean section was performed at 37 weeks of gestation, and 2520 g female infant with apgar score 8/9 was delivered. The baby was normal with no evidence of Beckwith-Wiedemann syndrome. Placenta of 20 × 16 × 2 cm, weighing 720 g, was bulky with grape like vesicles involving whole placenta. Microscopic examination revealed dilated villi and vessels with thick wall which was lacking trophoblast proliferation. Large hydropic stem villi with myxomatous struma and cistern formation were seen. PMD was histopathologically confirmed.

  15. Placental Mesenchymal Dysplasia: A Case Report

    Rachna Agarwal


    Full Text Available Introduction. A rare case of histologically proven placental mesenchymal dysplasia (PMD with fetal omphalocele in a 22-year-old patient is reported. Material and Methods. Antenatal ultrasound of this patient showed hydropic placenta with a live fetus of 17 weeks period of gestation associated with omphalocele. Cordocentesis detected the diploid karyotype of the fetus. Patient, when prognosticated, choose to terminate the pregnancy in view of high incidence of fetal and placental anomalies. Subsequent histopathological examination of placenta established the diagnosis to be placental mesenchymal dysplasia. Conclusion. On clinical and ultrasonic grounds, suspicion of P.M.D. arises when hydropic placenta with a live fetus presents in second trimester of pregnancy. Cordocentesis can detect the diploid karyotype of the fetus in such cases. As this condition is prognostically better than triploid partial mole, continuation of pregnancy can sometimes be considered after through antenatal screening and patient counseling. However, a definite diagnosis of P.M.D. is made only on placental histology by absence of trophoblast hyperplasia and trophoblastic inclusions.

  16. Miniature modified Faraday cup for micro electron beams

    Teruya, Alan T.; Elmer, John W.; Palmer, Todd A.; Walton, Chris C.


    A micro beam Faraday cup assembly includes a refractory metal layer with an odd number of thin, radially positioned traces in this refractory metal layer. Some of the radially positioned traces are located at the edge of the micro modified Faraday cup body and some of the radially positioned traces are located in the central portion of the micro modified Faraday cup body. Each set of traces is connected to a separate data acquisition channel to form multiple independent diagnostic networks. The data obtained from the two diagnostic networks are combined and inputted into a computed tomography algorithm to reconstruct the beam shape, size, and power density distribution.

  17. Cup anemometer calibration: effect of flow velocity distribution

    Piccato, A.; Spazzini, P. G.; Malvano, R.


    The effects of different working conditions and specifically of different velocity profiles on the output of a commercial cup anemometer were analysed experimentally. A simple mathematical model is also presented and provides results in line with the experiments. Results show that a cup anemometer with certain geometrical features can be calibrated through a rotating drag rig by correcting for the bias on the instrument output. The increase in uncertainty caused by this systematic correction was evaluated and applied to the results. The correction was validated by checking the compatibility of calibrations of a cup anemometer at the rotating rig and in a wind tunnel.

  18. Aerodynamic Analysis of Cup Anemometers Performance: The Stationary Harmonic Response

    Santiago Pindado


    Full Text Available The effect of cup anemometer shape parameters, such as the cups’ shape, their size, and their center rotation radius, was experimentally analyzed. This analysis was based on both the calibration constants of the transfer function and the most important harmonic term of the rotor’s movement, which due to the cup anemometer design is the third one. This harmonic analysis represents a new approach to study cup anemometer performances. The results clearly showed a good correlation between the average rotational speed of the anemometer’s rotor and the mentioned third harmonic term of its movement.

  19. Importance of nuclear medicine diagnostics in CUP syndrome; Stellenwert der nuklearmedizinischen Diagnostik bei CUP-Syndrom

    Winter, M.C.; Haberkorn, U.; Kratochwil, C. [Universitaetsklinikum Heidelberg, Abteilung fuer Nuklearmedizin, Heidelberg (Germany)


    The diagnostic work-up in patients with carcinoma of unknown primary (CUP) syndrome is extensive, highly time-consuming and cost-intensive and ultimately often fails to detect a primary site. In this context chest X-ray and computed tomography (CT) have been used as standard imaging modalities in CUP syndrome. Since the introduction of positron emission tomography (PET) evaluation of tumor vitality has become possible. Furthermore, PET-CT hybrid scanners allow the combination of functional and morphological imaging. Several meta-analyses have reported an additional overall detection rate between 24.5 % and 44 % by either PET or PET-CT. Metastatic localization (cervical versus extracervical) did not influence the performance. The sensitivity was usually high (> 80 %) but specificity was moderate ranging from 68 % to 88 % at best. If mentioned, the results obtained by fluorodeoxyglucose (FDG)-PET significantly changed the clinical management in approximately one third of the patients studied. In a direct comparison with PET alone, PET-CT did not depict significantly more primary tumors but was able to reduce false positive findings. To determine the real additional value of PET-CT in the diagnosis of CUP syndrome large prospective studies with more uniform inclusion criteria are needed. Despite the capabilities of FDG-PET-CT there is as yet no evidence that a potentially improved diagnostic algorithm is translated into a better patient outcome. Nevertheless, FDG-PET-CT should be performed in all CUP patients where conventional imaging failed to detect a primary site or the results are equivocal. In CUP patients with cervical lymph node metastases PET-CT should be carried out prior to panendoscopy to reduce the number of false negative biopsies. (orig.) [German] Die Diagnostik bei Carcinoma-of-unkown-primary(CUP)-Patienten ist meist umfangreich, sowohl sehr zeit- als auch kostenintensiv und verlaeuft dennoch haeufig frustran. Roentgenaufnahmen des Thorax und die

  20. Magnetic resonance imaging and magnetic resonance arthography of the acetabular labrum: Comparison with surgical findings; Magnetresonanztomographie und Magnetresonanzarthrographie des Labrum acetabulare: Vergleich mit operativen Ergebnissen

    Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Kramer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Institut fuer bildgebende Diagnostik am Schillerpark, Linz (Austria); Neuhold, A. [Krankenhaus Rudolfinerhaus, Vienna (Austria). Inst. fuer bildgebende Diagnostik; Urban, M. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Tschauner, C. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria); Hofmann, S. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)


    Aim of the study: To evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography in detecting acetabular labral lesions in correlation to surgical findings. Patients and methods: Forty patients (40 hips) with chronic hip pain and a strong clinical suspicion of labral lesions were examined with MRI in the coronal and axial plane by obtaining T{sub 1} weighted and proton density-weighted spin echo sequences. Additionally, MR arthrography of the high joint in the coronal oblique and sagittal oblique plane was performed by obtaining T{sub 1}-weighted three-dimensional gradient echo sequences after the intraarticular injection of gadopentate dimeglumine. The labra were prospectively evaluated on the basis of morphology, signal intensity, the presence or absence of a tear, and their attachment to the acetabulum. All patients underwent surgery, and the MRI findings and MR arthrography findings were compared with the surgical results. Results: Surgically, 34 labral lesions, and 6 normal labra were detected. MRI correctly depicted labral lesions in 24 patients and two normal labra, and MR arthrography correctly depicted labral lesions in 30 patients and 5 normal labra compared with the surgical results. The sensitivity of MRI was 80%, the accuracy of MRI was 65%, the sensitivity of MR arthrography was 95%, and the accuracy of MR arthgrography was 88%. Conclusions: MR arthrography enables considerably more accurate detection of acetabular labral lesions than MRI. MR arthrography should be the method of choice for the diagnosis of the presence or absence of acetabular labral lesions in patients with chronic hip pain and a strong clinical suspicion of labral lesions. (orig.) [German] Ziel: Die Bestimmung der Wertigkeit der konventionellen Magnetresonanztomographie (MRT) und der Magnetresonanzarthrographie (MR-Arthrographie) in der Abklaerung von Laesionen des Labrum acetabulare im Vergleich mit Operationsbefunden (Goldstandard). Methode

  1. Non-adenomatous forms of gastro-oesophageal epithelial dysplasia: an under-recognised entity?

    Serra, Stefano; Chetty, Runjan


    Foveolar dysplasia is an uncommon form of dysplasia that is encountered in the stomach and oesophagus in the context of Barrett’s oesophagus. Glands displaying foveolar dysplasia also show architectural abnormalities that are similar to those encountered in adenomatous dysplasia. However, from a cytological point of view, foveolar dysplasia glands are lined by low-cuboidal to columnar epithelium, the cytoplasm is often clear with round-to-oval nuclei. Nuclear stratification as seen in adenomatous dysplasia is not common, although there is loss of nuclear polarity, pleomorphism and mitotic activity. It is important to distinguish low-grade foveolar dysplasia from regenerative change.

  2. Comparison of Salter osteotomy and Tonnis lateral acetabuloplasty with simultaneous open reduction for the treatment of developmental dysplasia of the hip: midterm results.

    Bayhan, Ilhan A; Beng, Kubilay; Yildirim, Timur; Akpinar, Evren; Ozcan, Cagri; Yagmurlu, Firat


    The aim of this study was to compare the midterm clinical and radiological outcomes of the Salter osteotomy (SO) and Tonnis lateral acetabuloplasty (TLA) with concomitant open reduction for the treatment of developmental dysplasia of the hip. Twenty-five hips of 20 patients who underwent SO with open reduction and 26 hips of 23 patients who underwent TLA with open reduction were evaluated retrospectively. The average age of the patients at the time of the operation was 35.6 months in the SO and 36.6 months in the TLA group, without a statistically significant difference (P=0.836). The average follow-up times in the SO and TLA groups were 59.9 and 54.8 months, respectively (P=0.397). Preoperative (40.6° in the SO vs. 42.2° in the TLA, P=0.451) and last follow-up acetabular index (12° in the SO vs. 14° in the TLA, P=0.227) and center-edge angle measurements (30° in the SO vs. 26° in the TLA, P=0.069) did not show a statistically significant difference between the SO and TLA groups; however, early postoperative acetabular index improvement was better in the TLA group than in the SO group (21.2° in the SO vs. 17.2° in the TLA, P=0.014). According to the Severin grading system, both groups showed a similar number of good outcomes without a statistically significant difference (P=0.936). Clinical assessment on the basis of McKay's criteria showed similar good and excellent outcomes (P=0.936). Both osteotomy techniques showed similar satisfactory outcomes for the treatment of DDH in patients older than 18 months of age.

  3. Acetabular QCT in Total Hip Arthroplasty - a reliability study using porcine hips

    Mussmann, Bo Redder; Overgaard, Soren; Torfing, Trine;

    difference between the double measurements in SECT was 8 mg/cm3 (p=0.64) and 2 mg/cm3 in DECT (p=0.6). In the cemented concept the differences were 33 mg/cm3 (p=0.054) and 11 mg/cm3 (p=0.014), respectively. ICC was >0.90 regardless of scan mode and cup type. In both cup types the Bland-Altman limits...

  4. 肢体延长后行全髋关节置换治疗CroweⅣ型髋关节发育不良%Treatment of Crowe type Ⅳ developmental dysplasia of the hip with total hip arthroplasty after limb-lengthing with external fixator

    曹发奇; 杨述华; 许伟华; 叶树楠; 刘先哲; 冯勇; 张波


    Objective To retrospectively analyze the methods and clinical outcome to treat Crowe type Ⅳ developmental dysplasia of the hip (DDH) in young adults with total hip arthroplasty (THA) after limb-lengthing with external fixator.Methods From October 2007 to January 2012,12 patients with unilateral Crowe type Ⅳ DDH were treated with two-staged surgical method in our department.There were 2 males and 10 females with an average age of 25.7 years (range,18-35 years).In the first stage,the patients underwent soft tissue relaxation and iliofemoral distraction with use of an external fixator for 10-17 days.There were 1-2 cm distraction at the first time and 3-5 mm daily distraction.When the femoral head was distracted to the level of anatomical position,the second stage-THA was performed.All patients underwent uncemented prosthesis with bulk femoral head autograft for acetabular reconstruction.The acetabular cup was placed in the anatomical position in every patient.Shortening femoral osteotomies were not required.Results The mean time of first operation was 35.2±3.6 min,and hospital stay was 13.3±1.6 days.The mean time of second operation was 77.3±12.4 min,and hospital stay was 9.2±2.5 days.The average follow-up was 13.6±3.2 months,limb-length discrepancy was 5.6±1.5 cm on average preoperatively and 0.5±0.2 cm on average postoperatively.The Harris hip score was increased from 45.7±2.6 preoperatively to 92.3±3.3 postoperatively.All of the cases had acquired good hip and knee function.No patient suffered pin-site infection,hip joint infection,prosthesis loosening or deep vein thrombosis in our research.Transient nerve palsy occurred during the leg limb lengthening in 3 cases; calf skin numbness after THA occurred in 5 cases.Conclusion For the Crowe type Ⅳ DDH in young adults,normal limb length can be restored nearly and avoid nerve injury via continuously limb-lengthing with external fixator before THA.This method can get precise results,improve limb function

  5. Can a cup anemometer 'underspeed'? A heretical question

    Kristensen, L.


    An analysis of cup-anemometer dynamics has been carried out in order to determine whether the mean-wind velocity can have a negative bias. This would be contrary to the general belief that cup anemometers always overspeed. Compared to prior analyses, the effect of a possible nonlinearity...... of the calibration function is included. The conclusion is that neither longitudinal nor lateral velocity fluctuations can contribute significantly to a negative bias. However, if a cup anemometer has an angular response that falls below the ideal cosine response, there will, as demonstrated in the concluding...... discussion, be a negative contribution from the vertical velocity fluctuations to the total bias, and this contribution may even outbalance the positive contributions from the longitudinal velocity fluctuations. Concrete evidence of such exotic cup anemometer behaviour has not been reported in the literature....

  6. "The Gammage Cup" as Utopian Literature for Children.

    Russell, David L.


    Considers how Carol Kendall's fantasy novel, "The Gammage Cup," can be read as utopian literature for children. Provides a close reading and explication of Kendall's novel. Pronounces Kendall's novel a stimulating success providing hope for young readers. (HB)

  7. Ectodermal dysplasias associated with clefting: significance of scalp dermatitis.

    Fosko, S W; Stenn, K S; Bolognia, J L


    Several clinical syndromes are characterized by ectodermal dysplasia (ED) in association with clefting of the lip and/or palate. The three most commonly recognized entities are (1) the EEC syndrome (ectodermal dysplasia, ectrodactyly, cleft lip/palate); (2) the Rapp-Hodgkin syndrome with ectodermal dysplasia, cleft lip/palate, and mid facial hypoplasia; and (3) the Hay-Wells or AEC syndrome (ankyloblepharon, ectodermal defects, cleft lip/palate). The clinical characteristics of these entities as well as several less common syndromes are reviewed and summarized. The presence of scalp dermatitis in patients with the AEC syndrome and less often the Rapp-Hodgkin syndrome is emphasized.

  8. Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma.

    Nair, Sreelakshmi N; Kini, Raghavendra; Rao, Prasanna Kumar; Bhandarkar, Gowri P; Kashyp, Roopashri Rajesh; Rai, Manjunath; Naik, Neel; Santhosh, Athul


    Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma.

  9. Bilateral Cerebellar Cortical Dysplasia without Other Malformations: A Case Report

    Oh, Jung Seok; Ahn Kook Jin; Kim, Jee Young; Lee, Sun Jin; Park, Jeong Mi [Catholic University Yeouido St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of)


    Recent advances in MRI have revealed congenital brain malformations and subtle developmental abnormalities of the cerebral and cerebellar cortical architecture. Typical cerebellar cortical dysplasia as a newly categorized cerebellar malformation, has been seen in patients with Fukuyama congenital muscular dystrophy. Cerebellar cortical dysplasia occurs at the embryonic stage and is often observed in healthy newborns. It is also incidentally and initially detected in adults without symptoms. To the best of our knowledge, cerebellar dysplasia without any related disorders is very rare. We describe the MRI findings in one patient with disorganized foliation of both cerebellar hemispheres without a related disorder or syndrome

  10. Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma

    Rao, Prasanna Kumar; Bhandarkar, Gowri P.; Rai, Manjunath; Naik, Neel; Santhosh, Athul


    Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma. PMID:28101383

  11. Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

    Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.


    Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have detriment

  12. Distance constant of the Risø cup anemometer

    Kristensen, L.; Frost Hansen, O.


    The theory for cup-anemometer dynamics is presented in some detail and two methods of obtaining the distance constant lo are discussed. The first method is based on wind tunnel measurements: with a constant wind speed the cup anemometer is released from alocked position of the rotor and the increasing rotation rate recorded. It is concluded that the rapid increase in rotation rate makes the method very inaccurate. The second method consists of an analysis of turbulent, atmospheric of wind spe...

  13. An investigation of home disadvantage in Davis Cup tennis.

    Gayton, William F; Steinroeder, William; Bonnica, Corrine; Loignon, Andrew C


    Occurrence of the home disadvantage in Davis Cup tennis matches was examined by analyzing the outcome of Davis Cup finals matches from 1900 to 2007. There was no significant home disadvantage when Matches 1 and 2 were compared with Matches 4 and 5. However, there was a significant home disadvantage when Matches 1 and 2 were compared with Match 5. These findings are compared with those from earlier studies in which data from professional basketball and baseball were examined.

  14. Prevalence of disc cupping in non-glaucomatous eyes

    José Pablo Chiappe


    Full Text Available This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter 1.5 times (respectively the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81% were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg. There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001; therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7% small, 141 (76.6% medium and 16 (8.7% large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

  15. Manipulating Tournaments in Cup and Round Robin Competitions

    Russell, Tyrel; 10.1007/978-3-642-04428-1_3


    In sports competitions, teams can manipulate the result by, for instance, throwing games. We show that we can decide how to manipulate round robin and cup competitions, two of the most popular types of sporting competitions in polynomial time. In addition, we show that finding the minimal number of games that need to be thrown to manipulate the result can also be determined in polynomial time. Finally, we show that there are several different variations of standard cup competitions where manipulation remains polynomial.

  16. Watching the World Cup, one data point at a time

    Silver, Curtis


    Sound the vuvuzelas, the World Cup is officially here. The biggest sporting event in the world is set to break all kinds of viewing records. Sporting in the digital world is just as much about stats as it is about the game itself. Enter Brandwatch. The social media analytics company has taken it upon itself to track social media statistics for the entire run of the World Cup with their new real-time data visualization tool.

  17. Ceramide profile in hypohidrotic ectodermal dysplasia

    Jungersted, J. M.; Høgh, Julie Kaae; Hellgren, Lars


    Background. Hypohidrotic ectodermal dysplasia (HED) is a rare genetic disease. The clinical presentation includes lack of sweating ability, and an often widely spread dermatitis resembling atopic dermatitis (AD). In AD, the skin‐barrier defect is partly ascribed to the altered lipid profile...... in the stratum corneum and partly to mutations of the filaggrin genes. To our knowledge, no data are available about the epidermal lipid profile of HED. Aim. To compare the ceramide profile for patients with HED and AD. Methods. The ceramide profile and ceramide/cholesterol ratio were compared between patients...... ceramide 1, which was significantly higher in HED (P = 0.04). Conclusions. The increased ceramide 1 level found in HED compared with AD is known to play a role in the structure of the lipid bilayers. However, further studies are needed to identify the functional significance of these observations...

  18. Splash-cup plants accelerate raindrops to disperse seeds.

    Amador, Guillermo J; Yamada, Yasukuni; McCurley, Matthew; Hu, David L


    The conical flowers of splash-cup plants Chrysosplenium and Mazus catch raindrops opportunistically, exploiting the subsequent splash to disperse their seeds. In this combined experimental and theoretical study, we elucidate their mechanism for maximizing dispersal distance. We fabricate conical plant mimics using three-dimensional printing, and use high-speed video to visualize splash profiles and seed travel distance. Drop impacts that strike the cup off-centre achieve the largest dispersal distances of up to 1 m. Such distances are achieved because splash speeds are three to five times faster than incoming drop speeds, and so faster than the traditionally studied splashes occurring upon horizontal surfaces. This anomalous splash speed is because of the superposition of two components of momentum, one associated with a component of the drop's motion parallel to the splash-cup surface, and the other associated with film spreading induced by impact with the splash-cup. Our model incorporating these effects predicts the observed dispersal distance within 6-18% error. According to our experiments, the optimal cone angle for the splash-cup is 40°, a value consistent with the average of five species of splash-cup plants. This optimal angle arises from the competing effects of velocity amplification and projectile launching angle.

  19. Inversion of the acetabular labrum triggers rapidly destructive osteoarthritis of the hip: representative case report and proposed etiology.

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami


    The pathophysiology of rapidly destructive osteoarthritis (OA) of the hip is unknown. This study documented cases of inversion of the acetabular labrum, which has clinicoradiologic features similar to those of initial-stage rapidly destructive hip OA. Our study was based on a prospective review of data for 9 patients with rapidly destructive hip OA. Intraoperative findings showed that the anterosuperior portion of the acetabular labrum had inverted into the articular space, along with many fragments of articular cartilage, in all patients. Subchondral insufficiency fractures of the femoral heads were seen just under the inverted labra in 8 of the 9 patients. Inversion of the acetabular labrum may be involved in rapid joint-space narrowing and subchondral insufficiency fracture in rapidly destructive hip OA.

  20. Focal Cortical Dysplasia Type IIB and Human Papillomavirus

    J. Gordon Millichap


    Full Text Available Researchers at Temple University School of Medicine, Philadelphia, PA tested the hypothesis that human papillomavirus type 16 oncoprotein E6 (HPV16 E6 is present in human focal cortical dysplasia type IIB (FCDIIB specimens.

  1. New ECG Criteria in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

    M.G.P.J. Cox; J.J. van der Smagt; A.A.M. Wilde; A.C.P. Wiesfeld; D.E. Atsma; M.R. Nelen; L.M. Rodriguez; P. Loh; M.J. Cramer; P.A. Doevendans; J.P. van Tintelen; J.M.T. de Bakker; R.N.W. Hauer


    Background-Desmosomal changes, electric uncoupling, and surviving myocardial bundles in fibrofatty tissue characterize arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Resultant activation delay is pivotal for reentry and thereby ventricular tachycardia (VT). Current task force cr

  2. Initial respiratory management in preterm infants and bronchopulmonary dysplasia

    Ester Sanz López


    Full Text Available BACKGROUND: Ventilator injury has been implicated in the pathogenesis of bronchopulmonary dysplasia. Avoiding invasive ventilation could reduce lung injury, and early respiratory management may affect pulmonary outcomes. OBJECTIVE: To analyze the effect of initial respiratory support on survival without bronchopulmonary dysplasia at a gestational age of 36 weeks. DESIGN/METHODS: A prospective 3-year observational study. Preterm infants of 26 weeks (sensitivity =89.5% and specificity = 67%. The need for prolonged mechanical ventilation could be an early marker for the development of bronchopulmonary dysplasia. This finding could help identify a target population with a high risk of chronic lung disease. Future research is needed to determine other strategies to prevent bronchopulmonary dysplasia in this high-risk group of patients.

  3. Axial mesodermal dysplasia complex: a new case with parental consanguinity.

    Mota, C R; Azevedo, M; Rocha, G; Manuela, F; Coelho, R; Lima, M R


    A female is described with axial mesodermal dysplasia complex (AMDC) born to a consanguineous couple. This is thought to be the first description of a patient with AMDC born to consanguineous parents.

  4. Osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis

    Nirmal Raj Gopinathan


    Full Text Available Osteofibrous dysplasia or ossifying fibroma is an uncommon benign fibro-osseous lesion of childhood, commonly described in the maxilla and the mandible. Among long bones, it usually presents in the tibia as a painless swelling or anterior bowing. Ossifying fibroma of clavicle has never been reported in English literature, to the best of our knowledge. Here, we would like to present an unusual case of osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis.

  5. Streeter Dysplasia, from Pelvic to Digits: A Case Report

    Komang Agung Irianto; Luh Gede Djatu Anggita Dewi; Gana Adyaksa


    Background: Streeter dysplasia is a term to describe fetal congenital syndrome which mainly characterized by constriction band on appendages, prenatal amputations of extremities, and acrosyndactyly. This syndrome has wide range of clinical manifestation between patients, as reflected by many other terms to describe this syndrome. Case: The author reported five cases of Streeter dysplasia with constriction band on different locations of the body, with a patient having a constriction band aroun...

  6. Ectrodactyly, ectodermal dysplasia, cleft lip, and palate (EEC syndrome

    Mohita Marwaha


    Full Text Available The ectodermal dysplasias (EDs are a large and complex group of diseases. More than 170 different clinical conditions have been recognized and defined as ectodermal dysplasias. Commonly involved ectodermal-derived structures are hair, teeth, nails, and sweat glands. In some conditions, it may be associated with mental retardation. We report a case of 10-year-old male child with ectrodactyly, syndactyly, ED, cleft lip/palate, hearing loss, and mental retardation.

  7. The usefulness of nucleomedical procedures in diagnosis of fibrous dysplasia

    Otsuka, Nobuaki; Fukunaga, Masao; Ono, Shimato (Kawasaki Medical School, Kurashiki, Okayama (Japan)) (and others)


    Bone scintigraphy with {sup 99m}Tc-phosphorous compounds and {sup 67}Ga scintigraphy were performed in 8 patients (monostotic 3 cases, polyostotic 5 cases) with fibrous dysplasia. The tendency toward abnormal accumulation of radioactivity on bone scintigraphy was high in the tibia, maxilla, mandibule and ribs. The characteristics of the scintigraphic image at the sites of bone lesion in fibrous dysplasia were judged to be marked (++), moderate (+) or poor or minimal (-), according to the degree of accumulation of radioactivity. Eleven sites of fibrous dysplasia showed marked accumulation and 5 sites showed moderate accumulation. Poor or minimal accumulation was not observed in any fibrous dysplasia lesions. Sclerotic changes on bone roentgenograms appeared as marked accumulation of radionuclides on bone scintigraphy in all cases. Cystic changes on roentgenograms showed a tendency toward moderate accumulation on scintigrams. {sup 67}Ga scans were also all positive for 2 experimental cases (3 sites) of bone lesions of fibrous dysplasia. Thus, bone and {sup 67}Ga scintigraphies appear to be useful and essential in evaluating the pathophysiology of fibrous dysplasia. (author).

  8. Is There a Relationship between Ovarian Epithelial Dysplasia and Infertility?

    Gautier Chene


    Full Text Available Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups—an exposed group to ovulation induction (n = 30, an infertile group without stimulation (n = 35, and a spontaneously fertile control group (n = 62—in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls. In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group. Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.

  9. Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

    Khoo-Summers, Lynnette; Bloom, Nancy J


    Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing.

  10. Occult internal iliac arterial injury identified during open reduction internal fixation of an acetabular fracture: a report of two cases.

    Chaus, George W; Heng, Marilyn; Smith, Raymond M


    We present two cases of occult internal iliac arterial injury identified during operative reduction of a widely displaced posterior column posterior wall acetabular fracture. This complication was not recognised until reduction of the column fracture. There were no preoperative signs or symptoms indicative of a vascular injury. These cases emphasise the heightened awareness one must have when treating widely displaced posterior column fractures of the acetabulum, especially those fractures with extension into the greater sciatic notch, as previously formed clot can become dislodged and hemostasis lost. We also present management options when this complication occurs. We believe any surgeon treating acetabular fractures should be aware of this serious and potentially fatal complication.

  11. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine.

    Rozenfeld, Evgeni; Kalichman, Leonid


    Cupping is an ancient technique used in treating pain and various disorders. Different techniques have been developed over time, however, applying a cup to create suction over a painful area, is common to all. Dry or fire cupping, used on the intact skin, leaves bluish circular hematomas. Recently, interest in cupping has re-emerged and subsequently, several studies have begun to investigate the mechanisms of cupping therapy. Mechanically, cupping increases blood circulation, whereas physiologically it activates the immune system and stimulates the mechanosensitive fibers, thus leading to a reduction in pain. There is initial scientific evidence that dry cupping is able to reduce musculoskeletal pain. Since cupping is an inexpensive, noninvasive and low-risk (if performed by a trained practitioner) therapeutic modality, we believe that it should be included in the arsenal of musculoskeletal medicine. It is essential to perform additional studies clarifying the biological mechanism and clinical effects of cupping.

  12. Accuracy of methods to measure femoral head penetration within metal-backed acetabular components.

    Callary, Stuart A; Solomon, Lucian B; Holubowycz, Oksana T; Campbell, David G; Howie, Donald W


    A number of different software programs are used to investigate the in vivo wear of polyethylene bearings in total hip arthroplasty. With wear rates below 0.1 mm/year now commonly being reported for highly cross-linked polyethylene (XLPE) components, it is important to identify the accuracy of the methods used to measure such small movements. The aims of this study were to compare the accuracy of current software programs used to measure two-dimensional (2D) femoral head penetration (FHP) and to determine whether the accuracy is influenced by larger femoral heads or by different methods of representing the acetabular component within radiostereometric analysis (RSA). A hip phantom was used to compare known movements of the femoral head within a metal-backed acetabular component to FHP measured radiographically using RSA, Hip Analysis Suite (HAS), PolyWare, Ein Bild Roentgen Analyse (EBRA), and Roentgen Monographic Analysis Tool (ROMAN). RSA was significantly more accurate than the HAS, PolyWare, and ROMAN methods when measuring 2D FHP with a 28 mm femoral head. Femoral head size influenced the accuracy of HAS and ROMAN 2D FHP measurements, EBRA proximal measurements, and RSA measurements in the proximal and anterior direction. The use of different acetabular reference segments did not influence accuracy of RSA measurements. The superior accuracy and reduced variability of RSA wear measurements allow much smaller cohorts to be used in RSA clinical wear studies than those utilizing other software programs. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  13. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Reza Firoozabadi


    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  14. Fucntional and Radiological Outcome of Surgical Management of Acetabular Fractures in Tertiary Care Hospital

    Taufiq, Intikhab; Najjad, Muhammad Kazim Raheem; Khan, Naveed; Zia, Osama Bin


    Purpose Acetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital. Materials and Methods Total 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014. Patients were evaluated clinically with Harris hip score (HHS) and radiologically with Matta outcome grading. The factors examined include age, gender, fracture pattern, time between injury and surgery, initial displacement and quality of reduction on the final outcome. Results There were 34 males and 16 females. Mean age was 44.20±11.65 years while mean duration of stay was 9.28±2.36 days. Duration of follow-up was 24 months. Most common mechanism of injury was motor vehicle accident (n=37, 74.0%). Open reduction and internal fixation of fractures were performed using reconstruction plates. Mean HHS at 24 months was 82.36±8.55. The clinical outcome was acceptable (excellent or good) in 35 (70.0%) cases and not acceptable (fair or poor) in 15 (30.0%) cases. The radiological outcome was anatomical in 39 (78.0%) cases, congruent in 5 (10.0%) cases, incongruent in 6 (12.0%) cases. Conclusion Study results indicated that mechanism of injury, time between injury and surgery, initial degree of displacement and quality of reduction had significant effect on functional as well as radiological outcome. PMID:28097111

  15. Musik sebagai Wujud Eksistensi dalam Gelaran World Cup

    Michael HB Raditya


    Full Text Available We Are One atau “Ole Ola” merupakan lagu resmi dari gelaran World Cup. Setiap World Cupmempunyai lagu resminya ditiap gelarannya. Dalam keberlangsungannya, setiap lagu world cupmembutuhkan pertimbangan dalam pembentukannya. Aspek-aspek seperti budaya, sosial, politikdan lainya menjadi alasan penting dalam pembentukannya. Pembentukan Ole Ola didasarkan padaproses hibriditas budaya lokal dan global. Perpaduan samba dan hip hop menjadi variant dalampembentukannya. Perpaduan tersebut membentuk identitas untuk lagu itu sendiri, dan untuk gelaranworld cup. Eksistensi dari lagu sehingga makin terasa karena perpaduan yang membentuk identitas.Terlebih lagu tersebut tercipta tidak hanya karena gelaran, tetapi mempunyai fungsi dan guna untukmasyarakat. Musik sebagai media dalam mengkonstruksi pesan atas kepentingan. Musik membentukidentitas, dan mempunyai eksistensi dalam keberlangsungannya. Musik tidak lagi hanya berfungsisebagai musik saja, tetapi musik mempunyai peran dalam pembentukan identitas dan menjamineksistensi. Music as a form of Existance in the World Cup Performance. We are one or Ole Ola is the officialsong of the world cup performance. Every world cup has its official song in each event. In its development ofexistance, every song in world cup needs requires of consideration for creating process. Aspects such as cultural,social, politics and others become the important reason for creation. The creating proses of Ole Ola song isbased on the local and global cultural hybridity. The combination of samba and hip hop is a primary varianton creating process. The combination creates an identity for the song itself, and for world cup identity. Theexistance of Ole Ola is stronger because the combination may create the new identity. Moreover, the songcreated is not only for the event, but also has a function and purpose to society. Music is as a medium inconstructing the messages of interest. Music creates an identity, and has an existance in its

  16. Periprosthetic fractures of the acetabulum during cup insertion: posterior column stability is crucial.

    Laflamme, G-Yves; Belzile, Etienne L; Fernandes, Julio C; Vendittoli, Pascal A; Hébert-Davies, Jonah


    Periprosthetic hip fractures around acetabular components are rare with little information available to guide surgical management of these complex injuries. A retrospective review of intraoperative isolated acetabular periprosthetic fractures from three tertiary surgical units was done. A total of 32 patients were identified with 9 initially missed. Acetabular components were stable (type 1) in 11 patients with no failures; unstable (type 2) in 12 patients and treated with supplemental fixation. Non-union and displacement were correlated with absent posterior column plating. Missed fractures (type 3) had the highest reoperation rate. Anterior patterns all healed, whereas fractures with posterior column instability had a 67% failure rate. Periprosthetic acetabular fracture can heal successfully with posterior column stability. Plating is mandatory for large posterior wall fragments to achieve osteointegration.

  17. Hip Arthroscopy for Incarcerated Acetabular Labrum following Reduction of Traumatic Hip Dislocation: Three Case Reports

    Hwang, Jung-Mo; Lee, Woo-Yong; Noh, Chang-Kyun; Zheng, Long


    Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation. PMID:27777919

  18. Mathematical analysis of the effect of rotor geometry on cup anemometer response.

    Sanz-Andrés, Ángel; Pindado, Santiago; Sorribes-Palmer, Félix


    The calibration coefficients of two commercial anemometers equipped with different rotors were studied. The rotor cups had the same conical shape, while the size and distance to the rotation axis varied. The analysis was based on the 2-cup positions analytical model, derived using perturbation methods to include second-order effects such as pressure distribution along the rotating cups and friction. The comparison with the experimental data indicates a nonuniform distribution of aerodynamic forces on the rotating cups, with higher forces closer to the rotating axis. The 2-cup analytical model is proven to be accurate enough to study the effect of complex forces on cup anemometer performance.

  19. Mathematical Analysis of the Effect of Rotor Geometry on Cup Anemometer Response

    Ángel Sanz-Andrés


    Full Text Available The calibration coefficients of two commercial anemometers equipped with different rotors were studied. The rotor cups had the same conical shape, while the size and distance to the rotation axis varied. The analysis was based on the 2-cup positions analytical model, derived using perturbation methods to include second-order effects such as pressure distribution along the rotating cups and friction. The comparison with the experimental data indicates a nonuniform distribution of aerodynamic forces on the rotating cups, with higher forces closer to the rotating axis. The 2-cup analytical model is proven to be accurate enough to study the effect of complex forces on cup anemometer performance.

  20. Development of cup shaped microneedle array for transdermal drug delivery.

    Vinayakumar, Kadayar B; Hegde, Gopal M; Ramachandra, Subbaraya G; Nayak, Mangalore M; Dinesh, Narasimhian S; Rajanna, Konandur


    Microneedle technology is one of the attractive methods in transdermal drug delivery. However, the clinical applications of this method are limited owing to: complexity in the preparation of multiple coating solutions, drug leakage while inserting the microneedles into the skin and the outer walls of the solid microneedle can hold limited quantity of drug. Here, the authors present the fabrication of an array of rectangular cup shaped silicon microneedles, which provide for reduced drug leakage resulting in improvement of efficiency of drug delivery and possibility of introducing multiple drugs. The fabricated solid microneedles with rectangular cup shaped tip have a total height of 200 μm. These cup shaped tips have dimensions: 60 × 60 μm (length × breadth) with a depth of 60 μm. The cups are filled with drug using a novel in-house built drop coating system. Successful drug dissolution was observed when the coated microneedle was used on mice. Also, using the above method, it is possible to fill the cups selectively with different drugs, which enables simultaneous multiple drug delivery.

  1. Classification of operational characteristics of commercial cup-anemometers

    Friis Pedersen, T.; Schmidt Paulsen, U. [Risoe National Lab., Wind Energy and Atmospheric Physics Dept., Roskilde (Denmark)


    The present classification of cup-anemometers is based on a procedure for classification of operational characteristics of cup-anemometers that was proposed at the EWEC `97 conference in Dublin 1997. Three definitions of wind speed are considered. The average longitudinal wind speed (ID), the average horizontal wind speed (2D) and the average vector wind speed (3D). The classification is provided in these terms, and additionally, the turbulence intensities, which are defined from the same wind speed definitions. The commercial cup-anemometers have all been calibrated in wind tunnel for the normal calibrations and angular characteristics. Friction was measured by blywheel testing, where the surrounding temperatures were varied over a wide range. The characteristics of the cup-anemometers have been fitted to the heuristic dynamic model, and the response has been calculated in time domain for prescribed ranges of external operational conditions. The results are presented in ranges of maximum deviations of `measured` average wind speed. For each definition of wind speed and turbulence intensity, the cup-anemometers are ranked according to the most precise instrument. Finally, the most important systematic error sources are commented. (au)

  2. Octopus-like suction cups: from natural to artificial solutions.

    Tramacere, F; Follador, M; Pugno, N M; Mazzolai, B


    Octopus suckers are able to attach to all nonporous surfaces and generate a very strong attachment force. The well-known attachment features of this animal result from the softness of the sucker tissues and the surface morphology of the portion of the sucker that is in contact with objects or substrates. Unlike artificial suction cups, octopus suckers are characterized by a series of radial grooves that increase the area subjected to pressure reduction during attachment. In this study, we constructed artificial suction cups with different surface geometries and tested their attachment performances using a pull-off setup. First, smooth suction cups were obtained for casting; then, sucker surfaces were engraved with a laser cutter. As expected, for all the tested cases, the engraving treatment enhanced the attachment performance of the elastomeric suction cups compared with that of the smooth versions. Moreover, the results indicated that the surface geometry with the best attachment performance was the geometry most similar to octopus sucker morphology. The results obtained in this work can be utilized to design artificial suction cups with higher wet attachment performance.

  3. Dielectric elastomer actuators for octopus inspired suction cups.

    Follador, M; Tramacere, F; Mazzolai, B


    Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms.

  4. Barreled-beer cup vendor (FSCB-100); Tarunama cup benda (FSCB-100)



    Development was made on an automatic vending machine to vend barreled beer in a cup with stabilized quality. Its major features are as follows: (1) a double cooling system using water cooling and air cooling simultaneously was adopted to make it possible to maintain the beer freshness and pour it stably; (2) a full-automatic gas pressure control system was adopted to detect beer temperature, and adjust the pressure to adequate level; (3) an automatic rinsing system was adopted that has made troublesome pipe rinsing possible with just pressing a button to simplify maintenance work; and (4) a new automatic two-barrel changeover mechanism was developed to achieve first-in-first-out of barrels, control the freshness, suppress bubble generation, and reduce beer loss quantity. (translated by NEDO)

  5. Mandibuloacral dysplasia type A in childhood.

    Garavelli, L; D'Apice, M R; Rivieri, F; Bertoli, M; Wischmeijer, A; Gelmini, C; De Nigris, V; Albertini, E; Rosato, S; Virdis, R; Bacchini, E; Dal Zotto, R; Banchini, G; Iughetti, L; Bernasconi, S; Superti-Furga, A; Novelli, G


    Mandibuloacral dysplasia type A (MADA) is characterized by growth retardation, postnatal onset of craniofacial anomalies with mandibular hypoplasia, progressive acral osteolysis, and skin changes including mottled pigmentation, skin atrophy, and lipodystrophy. Owing to its slowly progressive course, the syndrome has been recognized in adults, and pediatric case reports are scarce. We present the clinical case of two children in whom the diagnosis of MADA was made at an unusually early age. A 5-year-old boy presented with ocular proptosis, thin nose, and short and bulbous distal phalanges of fingers. A 4-year-old girl presented with round face and chubby cheeks, thin nose, bulbous fingertips, and type A lipodystrophy. In both, a skeletal survey showed wormian bones, thin clavicles, short distal phalanges of fingers and toes with acro-osteolysis. Both children were found to be homozygous for the recurrent missense mutation, c.1580G>A, (p.R527H) in exon 9 of the LMNA gene. Thus, the phenotype of MADA can be manifest in preschool age; diagnosis may be suggested by short and bulbous fingertips, facial features, and lipodystrophy, supported by the finding of acral osteolysis, and confirmed by mutation analysis.

  6. [Imaging of oto-mandibular dysplasias].

    Montoya, P; Leboucq, N; Bigorre, M


    The modern imaging opened a possibility of precise exploration of otomandibular dysplasias. The techniques of browsing by IRM and CT Scan and the software of image processing which is associated with these techniques (three-dimensional, superposition and removing of the anatomical structures) allow to carry out a true anatomical dissection of the whole of these malformative syndromes. The study of the skeletal anomalies gains by specifying the disorders of development of the various mandibular segments: temporomandibular joint, ramus and horizontal branch and also, all cranio-maxillar structures: orbital rim, cranial basis. Study of masticatory muscles shows an important damage correlated with skeletal troubles and performs a grading of morphological and functional gravity. This analytical study emphasizes some malformative axis: malar axis in cases of mandibulofacial dystosis, temporomandibular axis in hemifacial microsomia. Modern imaging can appreciate, by development of three-dimensional cephalometry, growth anomalies and quantification of post therapeutical results. At last usefulness of imaging appears in therapeutic modelisation and in the field of Computer-Aided Planning of surgical techniques of osteotomies and overall maxillaries distractions.

  7. Arrhythmogenic Right Ventricular Dysplasia in Neuromuscular Disorders

    Finsterer, Josef; Stöllberger, Claudia


    OBJECTIVES Arrhythmogenic right ventricular dysplasia (ARVD) is a rare, genetic disorder predominantly affecting the right ventricle. There is increasing evidence that in some cases, ARVD is due to mutations in genes, which have also been implicated in primary myopathies. This review gives an overview about myopathy-associated ARVD and how these patients can be managed. METHODS A literature review was done using appropriate search terms. RESULTS The myopathy, which is most frequently associated with ARVD, is the myofibrillar myopathy due to desmin mutations. Only in a single patient, ARVD was described in myotonic dystrophy type 1. However, there are a number of genes causing either myopathy or ARVD. These genes include lamin A/C, ZASP/cypher, transmembrane protein-43, titin, and the ryanodine receptor-2 gene. Diagnosis and treatment are identical for myopathy-associated ARVD and nonmyopathy-associated ARVD. CONCLUSIONS Patients with primary myopathy due to mutations in the desmin, dystrophia myotonica protein kinase, lamin A/C, ZASP/cypher, transmembrane protein-43, titin, or the ryanodine receptor-2 gene should be screened for ARVD. Patients carrying a pathogenic variant in any of these genes should undergo annual cardiological investigations for cardiac function and arrhythmias. PMID:27790050

  8. Measuring acetabular component position on lateral radiographs - ischio-lateral method.

    Pulos, Nicholas; Tiberi Iii, John V; Schmalzried, Thomas P


    The standard method for the evaluation of arthritis and postoperative assessment of arthroplasty treatment is observation and measurement from plain films, using the flm edge for orientation. A more recent employment of an anatomical landmark, the ischial tuberosity, has come into use as orientation for evaluation and is called the ischio-lateral method. In this study, the use of this method was evaluated as a first report to the literature on acetabular component measurement using a skeletal reference with lateral radiographs. Postoperative radiographs of 52 hips, with at least three true lateral radiographs taken at different time periods, were analyzed. Component position was measured with the historical method (using the flm edge for orientation) and with the new method using the ischio-lateral method. The mean standard deviation (SD) for the historical approach was 3.7° and for the ischio-lateral method, 2.2° (p historical method, 19 (36.5%) hips had a SD greater than ± 4°, compared to six hips (11.5%) with the ischio-lateral method. By using a skeletal reference, the ischio-lateral method provides a more consistent measurement of acetabular component position. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicate that the angle measured with this simple method, which employs no further technology, increased time, or cost, is consistent and reproducible for multiple observers.

  9. 髋臼肿瘤的保肢治疗%Limb-salvage surgery for acetabular tumors



    Surgical treatment of acetabular tumors referred to extensive amputation or limb salvage therapy for the treatments of acetabulum and its surrounding bone destruction caused by primary malignant bone tumors or aggressive benign bone tumors. The surgical treatment of malignant tumors before 1991 was mainly half pelvic amputation. From March 1991 to April 2003, local resection and re-implantation using allograft pelvis or inactivated tumor bone shell reconstruction were performed. Limb salvage was achieved. Half of the patients were cured with weight-bearing walking with a cane or crutches. The authors have been using their own designed artificial pelvic prosthesis for reconstruction after 2003. They pointed out that mounting should be on pressure transforming line. The prosthesis and the host bone were fixed without loosening during the follow-up. The majority of patients have good hip function as the contralateral hip. Patients’ gait may be limp, but could be able to walk independently. With the diagnosis and treatment practice for years, pelvic tumors were not so uncommon and the treatment was challenging. The pathology of acetabular tumor was complex and diverse, and it was tumors nearing multiple organs that made it difficult to diagnose early and misdiagnosis and wrong treatment occurred. In accordance with the nature of the tumor, tumor size, amputation or limb salvage could be used. It was difficult to resect tumors and limb salvage was a type of rescue methods. Fully preoperative preparation and postoperative care should be emphasized. The disease could be cured with assistant chemotherapy and radiotherapy.

  10. Posterior acetabular column and quadrilateral plate fractures: fixation with tension band principles.

    Aly, Tarek A; Hamed, Hany


    Acetabular fractures can be classified into 5 simple and 5 associated fracture patterns. A significant amount of variation and complexity exists in these fractures patterns. Fractures of the posterior wall are the most common acetabular fractures. Comminution of the quadrilateral plate adds to fracture instability, and more rigid and stable internal fixation is mandatory. The goal of this study was to assess the results of reconstruction of comminuted posterior wall fractures of the acetabulum associated with quadrilateral plate fractures using the tension band technique. Twelve patients (9 men and 3 women) were included in the study. Mean patient age was 38.6 years (range, 24-47 years). Minimum follow-up was more than 2 years postoperatively. Reconstruction of the fracture included anatomic reduction of the fracture and fixation with a buttress plate for the posterior column and a prebent one-third tubular plate for the quadrilateral plate fracture. Clinical results were excellent in 58% of patients and good in 17% of patients. Radiologic results were excellent in 50% of patients and good in 17% of patients. Radiologically, based on the fracture gap postoperatively, 8 (66%) patients showed anatomic reduction, 2 (17%) showed good reduction, and 2 (17%) showed poor reduction. The study confirms that this method of reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum.

  11. Percutaneous Fixation of Anterior Column Acetabular Fracture in a Renal Transplant Recipient

    Halil Ceylan


    Full Text Available Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.

  12. Characterisation and classification of RISØ P2546 cup anemometer

    Friis Pedersen, Troels


    The characteristics of the RISØ P2546 cup anemometer were investigated in detail by wind tunnel and laboratory tests. The characteristics include accredited calibration, tilt response measurements for tilt angles between -40° to 40°, gust responsemeasurements at 8m/s and turbulence intensities...... of 10%, 16% and 23%, step response measurements at step wind speeds 3,7, 8, 11,9 and 15,2m/s, measurement of torque characteristics at 8m/s, rotor inertia measurements and measurements of friction ofbearings at temperatures -20°C to 40°C. Characteristics were fitted to a time domain cup anemometer model....... The characteristics were transformed into the CLASSCUP classification scheme, and were related to the cup anemometer requirements in the Danishcertification system and in the IEC 61400-121 Committee Draft....

  13. Characterisation and classification of RISØ P2546 cup anemometer

    Friis Pedersen, Troels


    The characteristics of the RISØ P2546 cup anemometer were investigated in detail by wind tunnel and laboratory tests. The characteristics include accredited calibration, tilt response measurements for tilt angles between -40° to 40°, gust responsemeasurements at 8m/s and turbulence intensities...... of 10%, 16% and 23%, step response measurements at step wind speeds 3,7, 8, 11,9 and 15,2m/s, measurement of torque characteristics at 8m/s, rotor inertia measurements and measurements of friction ofbearings at temperatures -20°C to 40°C. Characteristics were fitted to a time domain cup anemometer model....... The characteristics were transformed into the CLASSCUP classification scheme, and were related to the cup anemometer requirements in the Danishcertification system and in the IEC 61400-121 Committee Draft....

  14. A novel cupping-assisted plasma treatment for skin disinfection

    Xiong, Zilan; Graves, David B.


    A novel plasma treatment method/plasma source called cupping-assisted plasma treatment/source for skin disinfection is introduced. The idea combines ancient Chinese ‘cupping’ technology with plasma sources to generate active plasma inside an isolated, pressure-controlled chamber attached to the skin. Advantages of lower pressure include reducing the threshold voltage for plasma ignition and improving the spatial uniformity of the plasma treatment. In addition, with reduced pressure inside the cup, skin pore permeability might be increased and it improves attachment of the plasma device to the skin. Moreover, at a given pressure, plasma-generated active species are restricted inside the cup, raising local reactive species concentration and enhancing the measured surface disinfection rate. A surface micro-discharge (SMD) device is used as an example of a working plasma source. We report discharge characteristics and disinfection efficiency as a function of pressure and applied voltage.

  15. Treatment of Obstinate Diseases by Acupuncture and Cupping



    @@Acupuncture treatment integrated with cupping for enhancing the therapeutic effect is a technique in Yang's school of acupuncture carried forward from generation to generation. The author's grandfather created Yang's shallow puncturing and cupping therapy to enhance the effect of promoting blood flow and removing blood stasis in the light of his clinical experience. In this therapy, the gentle puncturing and heavy tapping are carried out with the seven-star needle until light bleeding occurs, followed by drawing out of pituita or stagnant blood and coagula by cupping, in an attempt to promote tissue regeneration by removing blood stasis for promoting the flow of qi and blood in the meridians. The therapy has been developed by Dr. Yang Yifang (the author's father) in clinical practice over the past six decades. Satisfactory therapeutic results have been obtained in clinical practice, which are introduced with examples below.

  16. Characterisation and classification of RISOe P2546 cup anemometer

    Friis Pedersen, T.


    The characteristics of the RISOe P2546 cup anemometer were investigated in detail by wind tunnel and laboratory tests. The characteristics include accredited calibration, tilt response measurements for tilt angles between -40 degC to 40 degC, gust response measurements at 8m/s and turbulence intensities of 10%, 16% and 23%, step response measurements at step wind speeds 3,7, 8, 11,9 and 15,2m/s, measurement of torque characteristics at 8m/s, rotor inertia measurements and measurements of friction of bearings at temperatures -20 degC to 40 degC. Characteristics were fitted to a time domain cup anemometer model. The characteristics were transformed into the CLASSCUP classification scheme, and were related to the cup anemometer requirements in the Danish certification system and in the IEC 61400-121 Committee Draft. (au)

  17. Earliest directly-dated human skull-cups.

    Silvia M Bello

    Full Text Available BACKGROUND: The use of human braincases as drinking cups and containers has extensive historic and ethnographic documentation, but archaeological examples are extremely rare. In the Upper Palaeolithic of western Europe, cut-marked and broken human bones are widespread in the Magdalenian (∼15 to 12,000 years BP and skull-cup preparation is an element of this tradition. PRINCIPAL FINDINGS: Here we describe the post-mortem processing of human heads at the Upper Palaeolithic site of Gough's Cave (Somerset, England and identify a range of modifications associated with the production of skull-cups. New analyses of human remains from Gough's Cave demonstrate the skilled post-mortem manipulation of human bodies. Results of the research suggest the processing of cadavers for the consumption of body tissues (bone marrow, accompanied by meticulous shaping of cranial vaults. The distribution of cut-marks and percussion features indicates that the skulls were scrupulously 'cleaned' of any soft tissues, and subsequently modified by controlled removal of the facial region and breakage of the cranial base along a sub-horizontal plane. The vaults were also 'retouched', possibly to make the broken edges more regular. This manipulation suggests the shaping of skulls to produce skull-cups. CONCLUSIONS: Three skull-cups have been identified amongst the human bones from Gough's Cave. New ultrafiltered radiocarbon determinations provide direct dates of about 14,700 cal BP, making these the oldest directly dated skull-cups and the only examples known from the British Isles.

  18. Thrombotic risk assessment questionary helps increase the use of thromboprophylaxis for patients with pelvic and acetabular fractures

    Haili Wang


    Conclusion: The assessment table can significantly improve the use of thromboprophylaxis after pelvic and acetabular fractures, which will likely reduce the incidence of DVT. Developing individual hospital prophylaxis strategy is an effective way to determine whether hospitalized patients should receive pharmacologic and/or mechanical prophylaxis or not.

  19. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.


    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  20. Epilepsy as a Rare Neurologic Manifestation of Oculodentodigitalis Dysplasia

    Mohammad BARZEGAR


    Full Text Available How to Cite this Article: Barzegar M, Sayadnasiri M, Tabrizi A. Epilepsy as a Rare Neurologic Manifestation of Oculodentodigitalis Dysplasia. Iran J Child Neurol 2012; 6(3: 39-43.Oculodentodigitalis dysplasia (ODDD is an extremely rare inherited disorderinvolving the development of the face, eyes, teeth and limbs. In addition,some patients develop neurological problems mostly a spastic paraparesisassociated with white matter abnormalities on magnetic resonance imaging.This report describes a patient with epilepsy, a rare neurologic manifestationof this syndrome.ReferencesJudisch GF, Martin-Casals A, Hanson JW, Olin WH.Oculodentodigital dysplasia. Four new reports and aliterature review. Arch Ophthalmol 1979 May;97(5:878-84.Paznekas WA, Boyadjiev SA, Shapiro RE, DanielsO, Wollnik B, Keegan CE, et al. Connexin 43(GJA1 mutations cause the pleiotropic phenotype of oculodentodigital dysplasia. Am J Hum Genet 2003 Feb;72(2:408-18.Parashari UC, Khanduri S, Bhadury S, Qayyum FA.Radiographic diagnosis of a rare case of oculodentodigital dysplasia. SA J Radiology 2011:134-6.van Es RJ, Wittebol-Post D, Beemer FA. Oculodentodigital dysplasia with mandibular retrognathism and absenceof syndactyly:a case report with a novel mutation in the connexin 43 gene. Int J Oral Maxillofac Surg 2007 Sep;36(9:858-60.Aminabadi NA, Ganji AT, Vafaei A, Pourkazemi M,Oskouei SG. Oculodentodigital dysplasia: disease spectrum in an eight-year-old boy, his parents and asibling. J Clin Pediatr Dent 2009 Summer;33(4:337-41.Loddenkemper T, Grote K, Evers S, Oelerich M, StogbauerF. Neurological manifestations of the oculodentodigital dysplasia syndrome. J Neurol 2002 May;249(5:584-95.Opjordsmoen S, Nyberg-Hansen R. Hereditary spasticparaplegia with neurogenic bladder disturbances and syndactylia. Acta Neurol Scand 1980 Jan;61(1:35-41.Farmer TW, Wingfield MS, Lynch SA, Vogel FS, HuletteC, Katchinoff B, et al. Ataxia, chorea, seizures, and dementia. Pathologic features of a newly

  1. Elastoplastic cup model for cement-based materials

    Yan ZHANG


    Full Text Available Based on experimental data obtained from triaxial tests and a hydrostatic test, a cup model was formulated. Two plastic mechanisms, respectively a deviatoric shearing and a pore collapse, are taken into account. This model also considers the influence of confining pressure. In this paper, the calibration of the model is detailed and numerical simulations of the main mechanical behavior of cement paste over a large range of stress are described, showing good agreement with experimental results. The case study shows that this cup model has extensive applicability for cement-based materials and other quasi-brittle and high-porosity materials in a complex stress state.

  2. Cup products in Hopf cyclic cohomology via cyclic modules I

    Rangipour, Bahram


    This is the first one in a series of two papers on the continuation of our study in cup products in Hopf cyclic cohomology. In this note we construct cyclic cocycles of algebras out of Hopf cyclic cocycles of algebras and coalgebras. In the next paper we consider producing Hopf cyclic cocycle from "equivariant" Hopf cyclic cocycles. Our approach in both situations is based on (co)cyclic modules and bi(co)cyclic modules together with Eilenberg-Zilber theorem which is different from the old definition of cup products defined via traces and cotraces on DG algebras and coalgebras.

  3. Calibration and Lag of a Friez Type Cup Anemometer

    Pinkerton, Robert M


    Tests on a Friez type cup anemometer have been made in the variable density wind tunnel of the Langley Memorial Aeronautical Laboratory to calibrate the instrument and to determine its suitability for velocity measurements of wind gusts. The instrument was calibrated against a Pitot-static tube placed directly above the anemometer at air densities corresponding to sea level, and to an altitude of approximately 6000 feet. Air-speed acceleration tests were made to determine the lag in the instrument reading. The calibration results indicate that there should be an altitude correction. It is concluded that the cup anemometer is too sluggish for velocity measurements of wind gusts.

  4. Sectoral labour market effects of the 2006 FIFA World Cup

    Feddersen, Arne; Maennig, Wolfgang


    Using the case of the 2006 FIFA World Cup, this study is the first to test the employment effects of a mega-sporting event on the basis of data that combines both regional and sectoral data. It is also the first study of sporting events to use a semi-parametric test method. Earlier studies on the...... on the World Cup could hardly identify any employment effects. In contrast, we find a small but significant positive employment effect on the hospitality sector. © 2012 Elsevier B.V....

  5. Recurring fibrous dysplasia of anthro maxillary with cranial base invasion

    Sousa, Kátia Maria Marabuco de


    Full Text Available Introduction: Fibrous dysplasia is an osseous lesion with an unknown etiology. It is characterized by the osseous maturation insufficiency. It may affect any bone, but the affection of craniofacial bones is the most critical for otorhinolaryngology. Maxilla is the most affected facial bone and the orbitary invasion is an uncommon event. The symptoms are unspecific and for its low suspicion and uncommonness, the diagnosis is generally late. The monostotic form presents a slow growth and asymptomatic course and needs to be followed up. The polyostotic type has a progressive behavior and is associated to recurrence and complications. Objective: To present two cases of patients with fibrous dysplasia diagnosis and describe the clinical presentation, radiological findings and the treatment of this pathology. Cases Report: Two cases of fibrous dysplasia are reported, which initially presented unspecific symptomatology, but with characteristic radiologic signs. They were submitted to surgical treatment for resection of the lesions and evolved with frequent recurrences with extensive affection of the facial sinuses, one patient had cranial base invasion and frontal craniotomy was needed for tumoral excision. Final Comments: Fibrous dysplasia is an uncommon osteopathy. The tomography is the choice method for characterization of the tumoral expansion, and helps in the surgical planning. The surgical strategy is indicated for symptomatic lesions, functions alterations or anatomic disorders. This article describes two uncommon manifestations of recurrent fibrous dysplasia with an extensive affection of anthro maxillary, ethmoidal and sphenoid sinuses, in addition to orbitary and cranial base invasion.

  6. Computed tomographic features of fibrous dysplasia of maxillofacial region

    Sontakke, Subodh Arun; Karjodka, Freny R [Nair Hospital Dental College, Mumba (India); Umarji, Hemant R [Government Dental College and Hospital, Mumbai (India)


    This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

  7. Craniofacial fibrous dysplasia - A review of current management techniques

    Yadavalli Guruprasad


    Full Text Available Fibrous dysplasia is a pathologic condition of bone of unknown etiology with no apparent familial, hereditary or congenital basis. Lichtenstein first coined the term in 1938 and in 1942 he and Jaffe separated it from other fibro-osseous lesions. It is a bone tumor that, although benign, has the potential to cause significant cosmetic and functional disturbance, particularly in the craniofacial skeleton. Its management poses significant challenges to the surgeon. Craniofacial fibrous dysplasia is 1 of 3 types of fibrous dysplasia that can affect the bones of the craniofacial complex, including the mandible and maxilla. Fibrous dysplasia is a skeletal developmental disorder of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Fibrous dysplasia represents about 2, 5% of all bone tumors and over 7% of all benign tumours. Over the years, we have gained a better understanding of its etiology, clinical behavior, and both surgical and non-surgical treatments.

  8. Mode-bifurcation upon pouring water into a cup that depends on the shape of the cup

    Nakata, Satoshi; Yamada, Akiko; Kitahata, Hiroyuki


    Mode-bifurcation that included hysteresis was investigated when water was poured into a cup via a water faucet. Three modes, i.e., accumulation flow (mode I), scattering flow (mode II), and open and shut oscillatory flow (mode III), could be produced by laterally changing the distance between the center of the cup and the landing point of water poured at a constant flow rate. Hysteresis in mode-bifurcation was observed when the distance was changed depending on the initial location of the water poured into the cup. Pendulum flow was also observed when water was poured into a shallow cell. The essential features of this mode-switching were reproduced by a numerical calculation as a function of the landing point of the poured water using two-variable (the size of the water hollow and the pressure on the water surface) differential equations that included the nature of reversed flow.

  9. Bilateral developmental dysplasia of the hip treated with open reduction and Salter osteotomy: analysis on the radiographic results☆☆☆

    Kotzias Neto, Anastácio; Ferraz, Adriana; Bayer Foresti, Franco; Barreiros Hoffmann, Rafael


    Objectives to evaluate the radiographic results from patients with bilateral developmental dysplasia of the hip (DDH) who underwent surgical treatment by means of open reduction and Salter osteotomy, with or without associated femoral shortening as described by Ombrédanne. Methods this was a retrospective descriptive study in which 21 patients with bilateral DDH (42 hips) were analyzed. They were treated at Hospital Infantil Joana de Gusmão (HIJG), with operations between August 1997 and October 2009. To evaluate the radiographic results, the acetabular index and the Wiberg center-edge angle were measured, and the Severin and Kalamchi–MacEwen classifications were used. Descriptive and parametric statistical analyses were used to evaluate the data. Results we did not observe any statistically significant difference in analyzing the radiographic parameters, making comparisons regarding the side affected, the order of the procedures and whether femoral shortening was performed, although there was a significant difference between them from before to after the operation. Conclusion open reduction in association with iliac osteotomy as described by Salter presented significant improvements in the radiographic parameters analyzed, comparing the pre- and postoperative values. This improvement occurred independently of whether Ombrédanne femoral shortening was performed. The most prevalent complication in the study group was avascular necrosis of the femoral head. PMID:26229826

  10. Genetics Home Reference: intrauterine growth restriction, metaphyseal dysplasia, adrenal hypoplasia congenita, and ...

    ... IMAGe syndrome intrauterine growth restriction, metaphyseal dysplasia, adrenal hypoplasia congenita, and genital anomalies Enable Javascript to view ... combination of intrauterine growth restriction, metaphyseal dysplasia, adrenal hypoplasia congenita, and genital anomalies is commonly known by ...

  11. Assessment of adult hip dysplasia and the outcome of surgical treatment

    Troelsen, Anders


    Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist, ...

  12. Clinical research evidence of cupping therapy in China: a systematic literature review

    Wang Qian; Shang Yongmei; Dong Shangjuan; Li Xun; Han Mei; Cao Huijuan; Xu Shu; Liu Jianping


    Abstract Background Though cupping therapy has been used in China for thousands of years, there has been no systematic summary of clinical research on it. This review is to evaluate the therapeutic effect of cupping therapy using evidence-based approach based on all available clinical studies. Methods We included all clinical studies on cupping therapy for all kinds of diseases. We searched six electronic databases, all searches ended in December 2008. We extracted data on the type of cupping...

  13. An overview of systematic reviews of clinical evidence for cupping therapy

    Huijuan Cao; Mei Han; Xiaoshu Zhu; Jianping Liu


    Background: As a traditional treatment method, cupping therapy is widely used in Asian countries. This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence-based approach. Methods: SRs that assessed the effectiveness of cupping therapy for any type of disease were searched through 6 electronic databases. Target diseases, cupping methods, numbers and types of included studies, quality of included trials, main results (includin...

  14. [Unilateral pulmonary agenesis, aplasia and dysplasia].

    Dembinski, J; Kroll, M; Lewin, M; Winkler, P


    Unilateral pulmonary anomalies are rare events of unknown etiology and large clinical variability. Neonatal history does not allow for a reliable prognosis. Interdisciplinary mangament includes prenatal diagnostics and obstetrics, genetics, neonatology, pediatric cardiology and surgery as well as pediatric orthopedics. Neonatal history and long-term follow-up in three patients are presented here including a discussion of prenatal diagnostics and the embryo-genetic basics of lung development. In three term neonates the diagnoses of unilateral pulmonary agenesis, aplasia and dysplasia, respectively, were based on angiography, MRI and bronchoscopy. Neonatal presentation and long-term consequences were studied in the context of the current literature. Neonatal complications ranged from mild repiratory distress to pulmonary failure requiring mechanical ventilation. One patient developed scoliosis on long-term follow-up. Cardiac failure or pulmonary hypertension did not occur during follow-up, in one case lung malformation was accompanied by VACTER-association. Unilateral lung malformation is frequently associated with other, singular or complex anomalies (e.g., renal and vascular). A possible relationship to disrupted regulation of embryo-genetic factors such as T-BOX genes, PITX2 and growth factors ( FGF10), which regulate ASYMMETRICAL pulmonary morphogenesis is discussed. Disruptive unilateral pulmonary malformations may serve as a model for embryological lung development and other anomalies (e.g., congenital diaphragmatic hernia, unilateral hypoplasia and CCAM). Prenatal diagnosis is characterized by unilateral hyperechogenicity of the affected lung. Neonatal presentation is determined by mediastinal shift which may be corrected by tissue-expander implantation. Associated anomalies require cytogenetic analysis and sequencing of currently known mutations. Long-term follow-up by echocardiography and pulmonary function testing is mandatory in these patients.

  15. 78 FR 36426 - Safety Zone; Queen's Cup; Lake Michigan; Milwaukee, WI


    ... DHS Department of Homeland Security FR Federal Register NPRM Notice of Proposed Rulemaking TFR... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Queen's Cup; Lake Michigan; Milwaukee, WI... Queen's Cup Regatta. The Queen's Cup Regatta is a race from Milwaukee, WI to Ludington, MI that...

  16. 77 FR 20846 - Certain Food Containers, Cups, Plates, Cutlery, and Related Items and Packaging Thereof...


    ... COMMISSION Certain Food Containers, Cups, Plates, Cutlery, and Related Items and Packaging Thereof... importation of certain food containers, cups, plates, cutlery, and related items and packaging thereof by... importation of certain food containers, cups, plates, cutlery, and related items and packaging thereof...


    Susi R. Puspita Dewi


    Full Text Available Ectodermal dysplasia is a rare congenital disease that affects several ectodermal structures. This disease is usually transmitted as an x-linked recessive trait in which the gene is carried by female and manifested in male. The orofacial characteristics of ectodermal dysplasia include anodontia or hypodontia, congenital teeth, underdevelopment of alveolar ridges and it is not uncommon for the face of an affected child to take on the appearance characteristic of old age, a prominent forehead, protuberant lips, a depressed nasal bridge, hypotricosis, and hypohidrosis. The treatment to manage orogacial disfigurement may afford the patient some measure of confidence, esthetics, function and speech. This case report describes the diagnosis and treatment of ectodermal dysplasia in an 18 year patient. The treatment included removable complete denture.

  18. Radiological analysis of polyostotic fibrous dysplasia in skeletal system

    Shin, Ma Rie; Kim, Jin Sik; Kim, Han Suk [National Medical Center, Seoul (Korea, Republic of); Park, Soo Soung [Chung Ang University College of Medicine, Seoul (Korea, Republic of)


    Over a period of recent 3 years, the 5 cases of polyostotic fibrous dysplasia were proven histologically at National Medical Center, and they were evaluated and analyzed radiologically and clinically. The results were as follows: 1. The age of 5 patients ranged from 12 to 21. 2. In general, clinical symptoms of these patients were pain of affected sites and swelling , fracture, walking disturbance of lower extremities. 3. The order of frequent site of polyostotic fibrous dysplasia was skull (4 cases), femur (3 cases), maxilla (2 case), humerus, tibia, rib, radius, metacarpal bone and phalanx. 4. The characteristic radiological findings of polyostotic fibrous dysplasia were multicystic lesions with ground glass appearance, osteosclerosis, cortical thinning and pathologic fracture and deformity of long bones. Particularly, in the extremities, multicystic radiolucencies, groud glass appearance, shepherd's crook and coxa vara deformities were noticed, and in the skull and maxilla, sclerotic changes were principally demonstrated.

  19. Polyostotic Fibrous Dysplasia of Cranio-Maxillofacial Area

    Han, Jin Woo; Kwon, Hyuk Rok; Lee, Jin Ho; Park, In Woo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kangnung National University, Kangnung (Korea, Republic of)


    Fibrous dysplasia is believed to be a hamartomatous developmental lesion of unknown origin. This disease is divided into monostotic and polyostotic fibrous dysplasia. Polyostotic type can be divided into craniofacial type, Lichtenstein-Jaffe type, and McCune-Albright syndrome. In this case, a 31-year-old female presented spontaneous loss of right mandibular teeth before 5 years and has shown continuous expansion of right mandibular alveolus. Through the radiographic view, the coarse pattern of the mixed radiopaque-lucent lesion was seen on the right mandibular body, and there was diffuse pattern of the mixed radiopaque-lucent lesion with ill-defined margin in the left mandibular body. In the right calvarium, the lesion had cotton-wool appearance. Partial excision for contouring, multiple extraction, and alveoloplasty were accomplished under general anesthesia for supportive treatment. Finally we could conclude this case was polyostotic fibrous dysplasia of cranio-maxillofacial area based on the clinical, radiologic finding, and histopathologic examination.

  20. Low-dose computed tomography to diagnose fetal bone dysplasias.

    Montoya Filardi, A; Guasp Vizcaíno, M; Gómez Fernández-Montes, J; Llorens Salvador, R

    We present a case of cleidocranial dysplasia diagnosed by low-dose fetal computed tomography (CT) in the 25th week of gestation. Severe bone dysplasia was suspected because of the fetus' low percentile in long bones length and the appearance of craniosynostosis on sonography. CT found no abnormalities incompatible with life. The effective dose was 5 mSv, within the recommended range for this type of examination. Low-dose fetal CT is a new technique that makes precision study of the bony structures possible from the second trimester of pregnancy. In Spain, abortion is legal even after the 22nd week of gestation in cases of severe fetal malformations. Therefore, in cases in which severe bone dysplasia is suspected, radiologists must know the strategies for reducing the dose of radiation while maintaining sufficient diagnostic quality, and they must also know which bony structures to evaluate.

  1. Pelvic orientation and assessment of hip dysplasia in adults

    Jacobsen, Steffen; Sonne-Holm, Stig; Lund, Bjarne;


    BACKGROUND: The study was performed to qualify the source material of 4151 pelvic radiographs for the research into the relationship between unrecognised childhood hip disorders and the development of hip osteoarthrosis, and to investigate the effect of varying degrees of pelvic tilt and rotation......: Wiberg's CE angle, Sharp's angle, the x-coordinate of Goodman's Cartesian coordinate system, and the acetabular depth ratio were significantly affected by varying rotation and inclination/reclination of the cadaver pelvises. Femoral head extrusion index was not significantly affected within the applied...

  2. Development of a classification system for cup anemometers - CLASSCUP

    Friis Pedersen, Troels


    Errors associated with the measurements of the wind speed are the major sources of uncertainties in power performance testing of wind turbines. Field comparisons of well-calibrated anemometers show a significant and not acceptable difference. TheEuropean CLASSCUP research project posed the object......Errors associated with the measurements of the wind speed are the major sources of uncertainties in power performance testing of wind turbines. Field comparisons of well-calibrated anemometers show a significant and not acceptable difference. TheEuropean CLASSCUP research project posed...... the objectives to quantify the errors associated with the use of cup anemometers, and to determine the requirements for an optimum design of a cup anemometer, and to develop a classification system forquantification of systematic errors of cup anemometers. The present report describes this proposed...... classification system. A classification method for cup anemometers has been developed, which proposes general external operational ranges to be used. Anormal category range connected to ideal sites of the IEC power performance standard was made, and another extended category range for complex terrain...

  3. Observation on Therapeutic Effects of Cupping Therapy for Allergic Rhinitis

    许荣正; 朱雪兰; 吴国民; 黄国琪


    @@ Allergic rhinitis is mainly characterized by the symptoms of sneezing,tickling sensation in the nose,runny nose,and nasal obstruction,and often occurs after invasion of pathogenic wind and cold.The author has treated 50 cases of this disease by applying cupping therapy on Shenque (CV 8).Now,the report is given as follows.

  4. Evaluating The RoboCup 2009 Virtual Robot Rescue Competition

    Balakirsky, S.; Carpin, S.; Visser, A.


    The 2009 RoboCup Competitions took place in Graz Austria in July of 2009. The Virtual Robot Rescue Competition included 11 competitors from 10 different countries. The main objective of this competition is to utilize teams of robots to perform an urban search and rescue (USAR) mission over both indo

  5. Teaching Transport Phenomena around a Cup of Coffee

    Condoret, Jean Stephane


    The very common situation of waiting for the cooling of a cup of coffee is addressed through a conventional engineering approach, where several important concepts of heat and mass transfer are used. A numerical and analytical solution of the differential equations of the problem are proposed, and assessed by comparing to simple experiments.…

  6. Ryder Cup ning rahvusvaheline kogemus teenindusvaldkonnast / Liis Meeras

    Meeras, Liis


    Iirimaal Dublini lähedal Kildare maakonna provintsis asuvas K-Clubis 22.-24. septembrini toimunud 36. Ryder Cup turniirist, mis on üks prestiizhikaim golfiüritus maailmas. Oma muljetest räägivad üritusel teenindanud turismitudengid TÜ Pärnu kolledzhist

  7. RoboCup Rescue Robot and Simulation Leagues

    Akin, H.L.; Ito, N.; Jacoff, A.; Kleiner, A.; Pellenz, J.; Visser, A.


    The RoboCup Rescue Robot and Simulation competitions have been held since 2000. The experience gained during these competitions has increased the maturity level of the field, which allowed deploying robots after real disasters (for example, Fukushima Daiichi nuclear disaster). This article provides

  8. Treatment of Acute Lumbar Sprain by Acupuncture plus Cupping

    WANG Jun-ying; WANG Si-you


    Fifty cases of acute lumbar sprain were treated by the combination of acupuncture, cupping and kinesitherapy. Forty-three cases were cured and 7 cases improved, the total effective rate being 100%. This therapy has an exact effect with a short course of treatment.

  9. Characterisation and classification of RISOe P2546 cup anemometer

    Friis Pedersen, T.


    The characteristics of the RISOe P2546 cup anemometer were investigated in detail, and all data presented in figures and tables. The characteristics include: wind tunnel calibrations, including an accredited calibration; tilt response meas-urements for tilt angles from -40 deg. C to 40 deg. C; gust response measurements at 8m/s, 10,5m/s and 13m/s and turbulence intensities of 10%, 16% and 23%; step response measurements at step wind speeds 4, 8, 12 and 15m/s; measurement of torque characteristics at 8m/s; rotor inertia measurements and measurements of friction of bearings at temperatures -20 deg. C to 40 deg. C. The characteristics are fitted to a time domain cup anemometer model, and the cup anemometer is put into the CLASSCUP classification scheme. The characteristics are also compared to the requirements to cup anemometers in the Danish wind turbine certification system and the CD and CDV of the revision of the standard IEC 61400-12. (au)

  10. Role of MRI in the diagnosis of insufficiency fractures of the sacrum and acetabular roof

    Grangier, C.; Garcia, J.; Howarth, N.R. [Departement de Radiologie, Division de Radiodiagnostic, Hopital Cantonal Universitaire de Geneve, CH-1211 Geneva 14 (Switzerland); May, M. [Departement de Radiologie, Division de Radio-Oncologie, Hopital Cantonal Universitaire de Geneve, CH-1211 Geneva 14 (Switzerland); Rossier, P. [Departement de Radiologie, Division de Medecine Nucleaire, Hopital Cantonal Universitaire de Geneve, CH-1211 Geneva 14 (Switzerland)


    Twenty patients with sacral and acetabular roof insufficiency fractures were reviewed retrospectively. There were 16 women (80%) and 4 males (age range 48-86 years, excluding an 8-year-old boy). Thirteen patients had a known tumour, and nine had received pelvic irradiation. All patients, except one who was asymptomatic, presented with low back or hip pain. In patients with a known tumor, metastases were suspected. Plain radiography (20), bone scintigrams (16), MR examinations (20), and bone densitometry (14) were performed. Nine patients also each had a CT scan. Results and conclusions. In three cases the CT scan performed 10-25 days after onset of symptoms was interpreted as normal. MR examination performed a few days after the CT scan showed in each of these three patients a fracture line with a band of edema. Scintigraphy was very sensitive, but the H-shaped pattern of sacral uptake, specific for an insufficiency fracture, was detected in only three of 16 cases. The earliest MR sign was medullary edema, seen as early as 18 days after the onset of symptoms. On spin echo (SE) T1-weighted images (T1WI), the hypointense signal of edema could mask a fracture line. On SE T2WI the fracture line could be detected within the hyperintense edema (10 of 17 patients with examinations including SE T2WI). However, in four patients a fracture of the sacrum was not seen on T2WI, these having been obtained in the axial plane. For this reason, intravenous gadolinium was injected, revealing a fracture line in 12 of 14 examinations, or fat suppression sequences were performed, revealing a fracture line in five of five cases. The total number of fractures detected was 17 [15 fractures of the sacrum (bilateral in 10 cases) and two of the acetabular roof]. At a later stage, the edema resolved and the fracture was clearly seen. The two cases of fracture of the acetabular roof were easily recognized at MRI, particularly in the sagittal plane. (orig./AJ). With 5 figs., 2 tabs.

  11. The economic value of the 2010 Soccer World Cup

    M. Saayman


    Full Text Available Purpose: The purpose of this article is to estimate the potential economic value of the 2010 Soccer World Cup for South Africa. Problem investigated: The Soccer World Cup (SWC is regarded as the largest sporting event to be hosted and South Africa is investing billions of Rand in the hosting thereof. Based on this the question that comes to mind is, what is the potential economic value of such an event? Previous research attempts to determine the economic value were limited in their focus on what should be included when economic modelling of events is conducted. Most of these studies were done by consultants on behalf of various government departments and consequently, the results of these attempts are criticised for their over-inflating and overestimations by various other researchers. Methodology: The literature review identified many aspects that need to be taken into account when modelling the economic impact of such an event together with aspects identified in the literature review. Lessons from the 2002 Korea/Japan and 2006 Germany Soccer World Cups were used as premise for our estimations. In this article, Computable General Equilibrium (CGE modelling is used to estimate the potential economic value. Findings: The results showed that the 2010 Soccer World Cup would in all probability have positive impacts on the economy of the country in terms of GDP growth and employment, with possible negative effects that include higher inflation and net export losses. Value of research: The value of this research lies in the approach that was followed firstly, by introducing lessons learned from previous World Cups as well as aspects not taken into consideration previously in economic modelling and secondly, by using CGE modelling in determining the economic value. Conclusion: The hosting of the 2010 Soccer World Cup is a major achievement not only for South Africa, but also for the rest of Africa, especially from a marketing point of view. From an

  12. Cerebral Infarct due to Fibromuscular Dysplasia: A Case Report

    Arzu Tay


    Full Text Available The course of cervicocephalic fibromuscular dysplasia is mainly asymptomatic. It is often found as an incidental finding on autopsy or angiography mostly in women and is commonly located in extracranial region of carotid artery. In the present article, we reported a 21 year-old man who has been initially accepted to our intensive care with a tentative diagnosis of cerebrovascular infarct after having symptoms of loss of consciousness and right hemiparesis. He later received a certain diagnosis of fibromuscular dysplasia after neuroimaging findings. This disorder should be considered in differential diagnosis of young stroke patients. [Cukurova Med J 2013; 38(2.000: 305-307

  13. Radiographic Classification of Developmental Dysplasia of the Hip

    José Julio Requeiro Molina


    Full Text Available For over a decade, abduction splinting has been the method of treatment for developmental dysplasia of the hip in the Paquito González Cueto University Pediatric Hospital. This paper is aimed at presenting the dynamic classification for this condition from a radiographic point of view. Representative schemes and radiographies of patients with various stages of developmental hip dysplasia were used for illustrating this classification. The dynamic behavior of the radiographic parameters used in the classification allows gathering diagnostic groups before, during and after treatment in order to assess its final results.

  14. Focal electroencephalography rhythm asymmetry due to focal skull fibrous dysplasia

    Michael A. Meyer


    Full Text Available An unusual pervasive and persistent asymmetry in background rhythm was found on surface electroencephalography (EEG recordings in a 22 year old with new onset of generalized seizure activity. Radiographic correlation with computed tomography, positron emission tomography and bone scan imaging uncovered that the higher amplitude left frontal-parietal background activity was related to a circumscribed area of left frontal-parietal fibrous dysplasia affecting the skull. This case report emphasizes that the presumed higher electrical conductance of fibrous dysplasia lead to a greater transparency of normal background rhythms, and must be taken into account as a form of breach rhythm for accurate EEG interpretation.

  15. Hip dysplasia and the performing arts: is there a correlation?

    Turner, Robert; O'Sullivan, Eilish; Edelstein, Jaime


    Dancers frequently present with hip pain. The etiology of this pathology has not been clearly identified from an anatomical perspective. Structural variations including hip dysplasia and dynamic variables from the foot to the pelvis will be discussed. Understanding the etiology as a structural entity, neuromuscular entity or a combination of the two, allows for a successful rehabilitative process and a successful return to dance. This article describes the possible correlation between hip dysplasia and hip pain in the dancer, the relationship of dance postures to the kinematic chain and outlines possible treatment strategies for management.

  16. Placental mesenchymal dysplasia associated with hepatic and pulmonary hamartoma.

    Tortoledo, Maria; Galindo, A; Ibarrola, C


    This report describes a 31-week stillborn female infant with placental mesenchymal dysplasia (PMD) in association with hepatic mesenchymal hamartoma (HMH) and pulmonary hamartoma. Placental mesenchymal dysplasia was initially misdiagnosed as a partial mole. However, histologically, no trophoblastic proliferation or inclusions were observed. Differential diagnosis of the hepatic mass with similar tumors is discussed. To our knowledge, this is the first case of lung hamartoma reported in a fetus and the first case related to PMD and HMH. A common anomalous development of the mesoderm, a reparative post-injury process and a genetic mechanism, have been proposed to explain their pathogenesis.

  17. Cup anemometry in wind engineering, struggle for improvement

    Albers, A.; Klug, H.; Westermann, D. [DEWI, Wilhelmshaven (Germany)


    Large deviations between measurements with cup anemometers of different types in turbulent air flow have recently been identified. The key problem resulting for the wind industry is that wind speed measurements performed with different anemometer types are not directly comparable. Solutions for this problem are believed to be found in a classification of cup anemometers or a correction among different cup anemometer types, while the focus must not necessarily lie on the determination of the true wind speed. The investigated cup anemometers fall roughly into two groups, namely the Risoee P2445b, the Vector A100 and the Metone 010C-1 anemometers tend to measure less wind speed in turbulent flow than the Thies 4.3303.22.X, the Friedrichs 4033.1100X and the Thies Compact anemometers. Measurements with a calibrated ultra sonic anemometer of type Gill Windmaster were closer to the first group at high wind speeds and to the latter group at lower wind speeds. Up to now all simple classification schemes oriented on basic physical properties of the cup anemometers, like the shape of the cups, the shape of the body or the size of the cups, were not successful. Also a classification of the cup anemometers according to their static response to vertically inclined air flow as measured in wind tunnels turned out to be inappropriate. A correction between the different groups of cup anemometers requires the knowledge which meteorological parameters have to be considered for the determination of the correction. From the existing measurements it is clear that such a correction is site specific and must account for the turbulence intensity. However, some cases appeared where at different sites with comparable turbulence intensity different deviations between the same pair of cup anemometers occurred which indicates that other flow parameters than the turbulence intensity also play an important role. (orig.) [German] Im Rahmen von Forschungsaktivitaeten unter Beteiligung des DEWI

  18. Histogram-driven cupping correction (HDCC) in CT

    Kyriakou, Y.; Meyer, M.; Lapp, R.; Kalender, W. A.


    Typical cupping correction methods are pre-processing methods which require either pre-calibration measurements or simulations of standard objects to approximate and correct for beam hardening and scatter. Some of them require the knowledge of spectra, detector characteristics, etc. The aim of this work was to develop a practical histogram-driven cupping correction (HDCC) method to post-process the reconstructed images. We use a polynomial representation of the raw-data generated by forward projection of the reconstructed images; forward and backprojection are performed on graphics processing units (GPU). The coefficients of the polynomial are optimized using a simplex minimization of the joint entropy of the CT image and its gradient. The algorithm was evaluated using simulations and measurements of homogeneous and inhomogeneous phantoms. For the measurements a C-arm flat-detector CT (FD-CT) system with a 30×40 cm2 detector, a kilovoltage on board imager (radiation therapy simulator) and a micro-CT system were used. The algorithm reduced cupping artifacts both in simulations and measurements using a fourth-order polynomial and was in good agreement to the reference. The minimization algorithm required less than 70 iterations to adjust the coefficients only performing a linear combination of basis images, thus executing without time consuming operations. HDCC reduced cupping artifacts without the necessity of pre-calibration or other scan information enabling a retrospective improvement of CT image homogeneity. However, the method can work with other cupping correction algorithms or in a calibration manner, as well.

  19. Radiological diagnostics in CUP syndrome; Radiologische Diagnostik des CUP-Syndroms

    Kazmierczak, P.M.; Nikolaou, K.; Graser, A.; Reiser, M.F.; Cyran, C.C. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Rominger, A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen (Germany)


    Imaging plays an essential role in the therapeutic management of cancer of unknown primary (CUP) patients for localizing the primary tumor, for the identification of tumor entities for which a dedicated therapy regimen is available and for the characterization of clinicopathological subentities that direct the subsequent diagnostic and therapeutic strategy. Modalities include conventional x-ray, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound as well as positron emission tomography (PET)-CT and MRI-PET. In whole body imaging CT has a high sensitivity for tumor entities which frequently present as a metastasized cancer illness. According to the current literature CT is diagnostic in 86% of patients with pancreatic carcinoma, in 36% of patients with colon carcinoma and in 74% of patients with lung carcinoma. Additionally a meta-analysis showed that for patients with squamous cell carcinoma and cervical lymph node metastases a positive diagnosis was possible in 22% of the cases using CT, in 36% using MRI and in 28-57% using 18F-fluorodeoxyglucose PET-CT ({sup 18}F-FDG PET-CT). In addition, MRI plays an important role in the localization of primary occult tumors (e.g. breast and prostate) because of its high soft tissue contrast and options for functional imaging. At the beginning of the diagnostic algorithm stands the search for a possible primary tumor and CT of the neck, thorax and abdomen is most frequently used for whole body staging. Subsequent organ-specific imaging examinations follow, e.g. mammography in women with axillary lymphadenopathy. For histological and immunohistochemical characterization of tumor tissue, imaging is also applied to identify the most accessible and representative tumor manifestation for biopsy. Tumor biopsy may be guided by CT, MRI or ultrasound and MRI also plays a central role in the localization of primary occult tumors because of superior soft tissue contrast and options for functional imaging (perfusion

  20. Arrhythmogenic right ventricular cardiomyopathy/dysplasia

    Basso Cristina


    Full Text Available Abstract Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D is a heart muscle disease clinically characterized by life-threatening ventricular arrhythmias. Its prevalence has been estimated to vary from 1:2,500 to 1:5,000. ARVC/D is a major cause of sudden death in the young and athletes. The pathology consists of a genetically determined dystrophy of the right ventricular myocardium with fibro-fatty replacement to such an extent that it leads to right ventricular aneurysms. The clinical picture may include: a subclinical phase without symptoms and with ventricular fibrillation being the first presentation; an electrical disorder with palpitations and syncope, due to tachyarrhythmias of right ventricular origin; right ventricular or biventricular pump failure, so severe as to require transplantation. The causative genes encode proteins of mechanical cell junctions (plakoglobin, plakophilin, desmoglein, desmocollin, desmoplakin and account for intercalated disk remodeling. Familiar occurrence with an autosomal dominant pattern of inheritance and variable penetrance has been proven. Recessive variants associated with palmoplantar keratoderma and woolly hair have been also reported. Clinical diagnosis may be achieved by demonstrating functional and structural alterations of the right ventricle, depolarization and repolarization abnormalities, arrhythmias with the left bundle branch block morphology and fibro-fatty replacement through endomyocardial biopsy. Two dimensional echo, angiography and magnetic resonance are the imaging tools for visualizing structural-functional abnormalities. Electroanatomic mapping is able to detect areas of low voltage corresponding to myocardial atrophy with fibro-fatty replacement. The main differential diagnoses are idiopathic right ventricular outflow tract tachycardia, myocarditis, dialted cardiomyopathy and sarcoidosis. Only palliative therapy is available and consists of antiarrhythmic drugs

  1. A feasibility study into the use of three-dimensional printer modelling in acetabular fracture surgery.

    Yu, A W; Duncan, J M; Daurka, J S; Lewis, A; Cobb, J


    There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient's unique anatomy can only lead to improved outcomes.

  2. Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy.

    Wassilew, G I; Perka, C; Janz, V; Krämer, M; Renner, L


    We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p transfusion after PAO significantly, without adverse effects such as an increased rate of VTE.

  3. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel


    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.


    V. A. Shilnikov


    Full Text Available Prevention of femoral head dislocation is becoming one of the most important tasks in view of increased number of total hip replacement procedures throughout the world. The purpose of the present work is to acquaint the surgeons with possibilities and the first experience of dual mobility acetabular component application as the most up-to-date solution to prevent dislocation of the femoral head in primary or revision arthroplasties. The paper is based on the literature data and presents a critical analysis of the causes of femoral head dislocation during hip replacement. The authors considered historical aspects and the first outcomes of dual mobility use in the European and Western countries, as well as own positive clinical experience with dual mobility system during a study of 36 patients with an increased risk of femoral head dislocation.

  5. A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

    A. W. Yu


    Full Text Available There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient’s unique anatomy can only lead to improved outcomes.

  6. Research on Transverse Acetabular Fracture Fixation Using Different Plate Attachment Methods

    Gediminas Gaidulis


    Full Text Available The article deals with the problem of transverse acetabular fracture fixation using different plate attachment methods. A 3D model of pelvis and hip joint structure was created and the design of three different fixation plates using SolidWorks was made. The plates were fixed at distances of 10, 20 and 30 mm from the acetabulum. The model was meshed into finite elements, a static external load of 2500 N was added and the analysis of stress distribution in plates and fracture displacement was performed. The obtained results showed that fracture displacement was quite similar in all fixation methods. However, the maximal stress in the nearest from the acetabulum plate was higher than yield strength. Thus, this placement is not eligible. The plate fixed at a distance of 30 mm from the acetabulum appeared the most suitable because of the smallest and symmetrical stress distribution in the plate.

  7. A Modified Stoppa (Technique Approach for Treatment of Pediatric Acetabular Fractures

    Mehmet Elmadag


    Full Text Available Pediatric acetabular fractures are rare, and anterior column fractures are even rarer. Generally, conservative treatment is applied. If there is displacement of more than 2 mm or findings of instability or fragments within the joint, then surgical treatment is applied. Anterior and posterior approaches may be used in surgical treatment. With pediatric patients, even greater care should be taken in the choice of surgery to be performed according to the fracture pattern to avoid postoperative triradiate cartilage damage. Therefore, minimally invasive surgery is more appropriate. We herein present a case of an acetabulum anterior column posterior hemitransverse fracture following a traffic accident, which was treated surgically using a modified Stoppa (technique approach.

  8. Acetabular shell deformation as a function of shell stiffness and bone strength.

    Dold, Philipp; Pandorf, Thomas; Flohr, Markus; Preuss, Roman; Bone, Martin C; Joyce, Tom J; Holland, James; Deehan, David


    Press-fit acetabular shells used for hip replacement rely upon an interference fit with the bone to provide initial stability. This process may result in deformation of the shell. This study aimed to model shell deformation as a process of shell stiffness and bone strength. A cohort of 32 shells with two different wall thicknesses (3 and 4 mm) and 10 different shell sizes (44- to 62-mm outer diameter) were implanted into eight cadavers. Shell deformation was then measured in the cadavers using a previously validated ATOS Triple Scan III optical system. The shell-bone interface was then considered as a spring system according to Hooke's law and from this the force exerted on the shell by the bone was calculated using a combined stiffness consisting of the measured shell stiffness and a calculated bone stiffness. The median radial stiffness for the 3-mm wall thickness was 4192 N/mm (range, 2920-6257 N/mm), while for the 4-mm wall thickness the median was 9633 N/mm (range, 6875-14,341 N/mm). The median deformation was 48 µm (range, 3-187 µm), while the median force was 256 N (range, 26-916 N). No statistically significant correlation was found between shell stiffness and deformation. Deformation was also found to be not fully symmetric (centres 180° apart), with a median angle discrepancy of 11.5° between the two maximum positive points of deformation. Further work is still required to understand how the bone influences acetabular shell deformation.

  9. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Rosaria M. Ruggeri


    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  10. Design and Research on Auto-vending Machine for Cupped Beverage

    Xiaowei Jiang


    Full Text Available The aim of this research is to design an auto-vending machine for cupped beverage, specifically researching its working principle, the design of beverage powder transporting mechanism, paper cups detaching mechanism and paper cups slide mechanism. The article elaborates that the design of beverage powder transporting mechanism is mainly the selection of electromagnet and the determination of electromagnet stroke, requiring that the electromagnet stroke and the maximum weight that the electromagnet could bear should have rationality, to ensure its safe operation; the design of paper cups detaching mechanism mainly includes selecting electric motor and V belt; the design of paper cups slide mechanism includes the design of slide structure and the force analysis when the paper cup slides on the slide. And then the working principle and working process of the auto-vending machine for cupped beverage is introduced, based on which the conclusion has been reached.

  11. Colorectal cancer and dysplasia in inflammatory bowel disease

    Timothy L Zisman; David T Rubin


    Both ulcerative colitis and Crohn's disease carry an increased risk of developing colorectal cancer.Established risk factors for cancer among patients with inflammatory bowel disease (IBD) include the younger age at diagnosis,greater extent and duration of disease,increased severity of inflammation,family history of colorectal cancer and coexisting primary sclerosing cholangitis.Recent evidence suggests that current medical therapies and surgical techniques for inflammatory bowel disease may be reducing the incidence of this complication.Nonetheless heightened vigilance and a careful,comprehensive approach to prevent or minimize the complications of invasive cancer are warranted in this unique cohort of patients.Current guidelines for the prevention and early detection of cancer in this high risk population are grounded in the concept of an inflammation-dysplasia-carcinoma sequence.A thorough understanding of the definition and natural history of dysplasia in IBD,as well as the challenges associated with detection and interpretation of dysplasia are fundamental to developing an effective strategy for surveillance and prevention,and understanding the limitations of the current approach to prevention.This article reviews the current consensus guidelines for screening and surveillance of cancer in IBD,as well as presenting the evidence and rationale for chemoprevention of cancer and a discussion of emerging technologies for the detection of dysplasia.

  12. QT dispersion in patients with arrhythmogenic right ventricular dysplasia

    Benn, Marianne; Hansen, P S; Pedersen, A K


    , of electrical instability. The present study was conducted to assess the occurrence of QT dispersion and its modulation during treatment with sotalol. Methods Twenty-five patients with the diagnosis of arrhythmogenic right ventricular dysplasia were studied retrospectively. Fourteen patients were considered low...

  13. Comments on frontonasal dysplasia, ocular hypertelorism and dystopia canthorum.

    Peterson, M Q; Cohen, M M; Sedano, H O; Frerichs, C T


    The mean canthal index values of patients with frontonasal dysplasia are tested for differences in facies A, B, C, and D. A general discussion of ocular hypertelorism and dystopia canthorum is presented. Ocular hypertelorism is considered a sign which may occur in a variety of disorders. Quantitative methods for determining ocular hypertelorism are critically reviewed.

  14. RUNX2 analysis of Danish cleidocranial dysplasia families

    Hansen, L; Riis, A K; Silahtaroglu, A;


    Cleidocranial dysplasia (CCD) is an autosomal dominant inherited disease caused by mutations in the Runt gene RUNX2. Screening of 19 Danish CCD families revealed 16 pathogenic mutations (84%) representing 8 missense mutations, 2 nonsense mutations, 4 frame-shift mutations and 2 large deletions...

  15. Craniofacial and temporal bone CT findings in cleidocranial dysplasia

    Gonzalez, Guido E. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Clinica Alemana de Santiago, Departamento de Imagenes, Santiago (Chile); Caruso, Paul A.; Curtin, Hugh D. [Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Radiology, Boston, MA (United States); Small, Juan E. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Radiology, Boston, MA (United States); Jyung, Robert W. [Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Otology, Boston, MA (United States); Troulis, Maria J. [Massachusetts General Hospital and Harvard Medical School, Department of Oral and Maxillofacial Surgery, Boston, MA (United States)


    Cleidocranial dysplasia (CCD) is a multistructural polyostotic genetic disorder that results from mutation of the CBFA1 gene. Hearing loss is a frequent finding in CCD. We describe the CT craniofacial findings in CCD and provide a comprehensive discussion of the CT temporal bone findings in these patients. (orig.)

  16. [Right ventricular dysplasia and sudden death in young people].

    Maresi, E; Albano, N; Procaccianti, P; Campesi, G


    In this study two autoptic cases of right ventricular dysplasia, observed in young and asymptomatic subjects who died suddenly are reported. In these patients, the "primary" myocardial atrophy involved the right ventricle, the right atrium and the conduction system: the sinoatrial node and the internodal pathways (in both cases) and the hisian bifurcation (only in the second case). The primary ventricular dysplasia was always associated with "secondary" transmural hyperplasia of the sub-epicardial fat tissue except for the anterior wall of the pulmonary infundibulum. According to the findings observed, we think that: 1) in all cases of right ventricular dysplasia a careful examination of the conduction system must be performed due to the fact that the lethal arrhythmias can be not only "hyperkinetic" but also "hypokinetic" arrhythmias; 2) right ventricular dysplasia is a dysplastic-congenital disease and transmural fatty hyperplasia depends both on "primary" myocardial atrophy and on the presence of sub-epicardial fat tissue; the latter is related to the age of the patient.

  17. Congenital heart defects in oculodentodigital dysplasia: Report of two cases.

    Izumi, Kosuke; Lippa, Andrew M; Wilkens, Alisha; Feret, Holly A; McDonald-McGinn, Donna M; Zackai, Elaine H


    Oculodentodigital dysplasia is caused by mutations in the GJA1 gene. Oculodentodigital dysplasia presents with a spectrum of clinical features including craniofacial, ocular, dental, and limb anomalies. Although recent findings implicate the major role of GJA1 during cardiac organogenesis, congenital heart defects are infrequently reported in oculodentodigital dysplasia. Here we report on two patients with GJA1 mutations presenting with cardiac malformations and type III syndactyly. Patient 1 presented with pulmonary atresia, an intact septum, right ventricular hypoplasia and tricuspid stenosis. The infant had a small nose, thin columella and bilateral 4-5 syndactyly of the fingers. A de novo c.226C>T (p.Arg76Cys) mutation was identified. Patient 2 presented at 6 months with a ventricular septal defect. The child had hypoplastic alae nasi with a thin columella and bilateral 4-5 syndactyly of the digits. A de novo missense mutation, c.145C>G (p.Gln49Glu) was found. Our two patients underscore the importance of cardiac evaluations as part of the initial workup for patients with findings of oculodentodigital dysplasia. Conversely, those patients with type III syndactyly and congenital heart defect should be screened for GJA1 mutations.

  18. Pathogenetics of alveolar capillary dysplasia with misalignment of pulmonary veins

    Szafranski, P.; Gambin, T.; Dharmadhikari, A.V.; Akdemir, K.C.; Jhangiani, S.N.; Schuette, J.; Godiwala, N.; Yatsenko, S.A.; Sebastian, J.; Madan-Khetarpal, S.; Surti, U.; Abellar, R.G.; Bateman, D.A.; Wilson, A.L.; Markham, M.H.; Slamon, J.; Santos-Simarro, F.; Palomares, M.; Nevado, J.; Lapunzina, P.; Chung, B.H.; Wong, W.L.; Chu, Y.W.; Mok, G.T.; Kerem, E.; Reiter, J.; Ambalavanan, N.; Anderson, S.A.; Kelly, D.R.; Shieh, J.; Rosenthal, T.C.; Scheible, K.; Steiner, L.; Iqbal, M.A.; McKinnon, M.L.; Hamilton, S.J.; Schlade-Bartusiak, K.; English, D.; Hendson, G.; Roeder, E.R.; DeNapoli, T.S.; Littlejohn, R.O.; Wolff, D.J.; Wagner, C.L.; Yeung, A.; Francis, D.; Fiorino, E.K.; Edelman, M.; Fox, J.; Hayes, D.A.; Janssens, S.; Baere, E. De; Menten, B.; Loccufier, A.; Vanwalleghem, L.; Moerman, P.; Sznajer, Y.; Lay, A.S.; Kussmann, J.L.; Chawla, J.; Payton, D.J.; Phillips, G.E.; Brosens, E.; Tibboel, D.; Klein, A.; Maystadt, I.; Fisher, R.; Sebire, N.; Male, A.; Chopra, M.; Pinner, J.; Malcolm, G.; Peters, G.; Arbuckle, S.; Lees, M.; Mead, Z.; Quarrell, O.; Sayers, R.; Owens, M.; Shaw-Smith, C.; Lioy, J.; McKay, E.; Leeuw, N. de; Feenstra, I.; Spruijt, L.; Elmslie, F.; Thiruchelvam, T.; Bacino, C.A.; Langston, C.; Lupski, J.R.; Sen, P.; Popek, E.; Stankiewicz, P.


    Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is a lethal lung developmental disorder caused by heterozygous point mutations or genomic deletion copy-number variants (CNVs) of FOXF1 or its upstream enhancer involving fetal lung-expressed long noncoding RNA genes LINC0108

  19. Prenatal diagnosis and epidemiology of multicystic kidney dysplasia in Europe

    Winding, Louise; Loane, Maria; Wellesley, Diana;


    OBJECTIVES: The aim of this study is to describe the prenatal diagnosis and epidemiology of multicystic kidney dysplasia (MCKD). METHODS: The study is based on routinely collected data from a European database of major congenital anomalies including 13 registries with cases born in 1997...

  20. Endoscopic options for treatment of dysplasia in Barrett'sesophagus


    Recent advances in the endoscopic treatment of dysplasiain Barrett's esophagus (BE) have allowed endoscopists toprovide effective and durable eradication therapies. Thisreview summarizes the available endoscopic eradicationtechniques for dysplasia in patients with BE includingendoscopic mucosal resection, endoscopic submucosaldissection, photodynamic therapy, argon plasma coagulation,radiofrequency ablation and cryotherapy.